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The American Heart Association had not published any position regarding this. Our current recommendations remain in effect to do compressions until the shock is ready to be delivered and to clear the patient prior to the release of energy. Regards, ECC Programs American Heart Association 7272 Greenville Avenue Dallas, TX 75231

So who watched House tonight? I was seriously peeved when he looked at the Paramedic and told him to start an IV in the patients tibia. The Paramedic gave a bland stare and then House made a comment about how they don't teach that in EMT school. First of all, that was deeply offensive to our profession. Secondly, IOs are most certainly taught in Paramedic training around the nation. The mere fact that the Paramedic had to step away from the patient and ask House what to do was insulting. Why does every show that has an EMT in it have to make us look like a bunch of inept fools who can't do a professional job on our best days? House is one of my favorite shows, but I was ticked tonight.

I read, with great interest, the article in this months JEMS concerning retraining rescuers to keep their hands on the patient during biphasic defibrillation. I was intrigued, but not convinced that it is entirely safe, so I emailed Zoll to inquire about the safety. I also Googled to see if there were any articles that spoke to the subject. Below is what I discovered. What do the rest of you know about this? Anyone else hesitant to keep their hands ON the patient DURING defibrillation? I wrote to Zoll and asked them about the safety of keeping your hand on a patient during defibrillation. They responded that you should NEVER leave your hands on a patient during biphasic or monophasic defibrillation, because the rescuer could receive the shock themselves. That being said, I did look for scholarly articles that supported the claim that hands on defibrillation is safe for biphasic defibrillation. I would be interested in seeing some of the science behind this article. I wrote the AHA for their comment and have not received a response. What follows is the responses I got from Zoll and the link to one scholarly article that I found. "Always stand clear of victim when delivering a shock. Defibrillation energy delivered to the victim may be conducted through the victim's body and cause a lethal shock to those touching the victim." I responded for clarification and received the following response. "ZOLL Medical does advise on how to train EMS personnel. ZOLL Medical can advise that EMS personnel should always stand clear of victim when delivering a shock. Defibrillation energy delivered to the victim may be conducted through the victim's body and cause a lethal shock to those touching the victim." Then I found this article online: http://circ.ahajourn...tent/short/C...

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In my experience, many times they can afford the cab and/or they may even have an operating vehicle in their driveway, but they know they're not going to have to pay the ambulance bill, so they call us and like idiots, we keep taking them. I,too, worry about the potential can of worms this could unleash...but we've got to stop GIVING away our services to non-emergencies...so, who has other suggestions?

I just sent Kotex an email requesting information about this for EMS purposes. We'll see what kind of response I receive. I'll post it here, if I get one.

I get it Richard...I just don't think I want to support a lobbying group that is not supporting the things I think are important or that are supporting things I strongly disagree with. They're very vague on the things most important in America, like this Healthcare Bill, but take a position on something as insignificant as EMT participation in capital punishment. They have a position statement on the Healthcare Bill, but it couldn't be any less committal than it already is.

It's ironic that someone posted on this thread bringing it to my attention again. My NAEMT membership is due to renew. I have decided I am not renewing my membership with the NAEMT for two reasons. One is because I strongly disagree with their position on EMS participation in executions. The second reason is because the NAEMT has not made a public stand denouncing the Healthcare Bill. I, for one, support capital punishment and I think someone has to carry out the sentences. It's not like the people being executed don't deserve it.

I know many people who volunteer mostly because there is a need in their community. And while you're correct, the initial training is the same, many volunteer's do not do as frequent as training or get some of the additional certifications that working for a paid service would provide. I think that if you were to do a comparative study on the certifications paid staff have compared to the certifications volunteers have, you'd see the point I'm trying to make. I'm not saying anything to disparage the volunteers, I just think paid services tend to invest more into the education of their staff than volunteer services can afford to. I hope you feel better soon.

Not at all. I'm saying without volunteer's the EMS system we enjoy would be even farther behind than you seem to think it is.

This is as absurd as claiming you're too fat and that the IV attempt is cruel. If that person was having a heart attack and they tried multiple times to start the IV for the meds and the patient was saved then that would be okay. If you have to be stuck, however, multiple times to be executed then it is cruel. Come on, you're being executed because you showed no mercy for your victim(s). Frankly, I think that executions should happen more frequently for more types of crimes and I don't really care how cruel and/or inhumane the process is. Violently rape someone...death. Molest a child....death. Torture a civilian....death. The list goes on and on.

Volunteer Departments are the backbone of EMS in America. The problem with Volunteer's is that they're volunteers. They're not required to participate in all of the training that a typical career EMS provider goes through. They also don't run the call volume that paid services do. EMS is not typically their passion or career choice, but they do it because if they didn't, who else would? As a state regulator, I see many different kinds of agencies. I see good and bad volunteer agencies and I see good and bad paid agencies. Volunteer's most generally do the best they can with the resources they have. Sometimes they knock it out of the park and other times they do just enough to get by. I can say that of some paid agencies. Do the best you can to thank them for their valuable service and encourage them to improve in areas of weakness. Without volunteers EMS would not be the success it is in America today.

I think this was a good call by the prosecutor's office. No matter what you think of this matter in general, the medic ended a bad situation and stopped it from getting worse.

Welcome! Tis a noble profession that you've chosen to pursue. You will need to become American Heart Association CPR certified, but many of the EMT programs include that in their curriculum. Not all do, but many do. So wait until you find a program. It can't hurt you to take an anatomy and physiology class. As you progress in levels of training, each level will teach you more about A&P, but I have found -having been an EMT-Basic, EMT-Intermediate and now an EMT-Paramedic - that none of the EMT level A&P classes are as in depth as an acutal college level A&P class. I always recommend becoming Nationally Registered as an EMT at any level. Most states require NREMT for reciprocity and initial licensing. At any rate, the answering to your question is no. You must attend an approved EMT program, complete the clinical and field internship, take a written and a practical examination to challenge any level of EMT test. For Indiana, if you go here, it will help you locate programs in the Indy area. Wishard has an ambulance service and if you contact their EMS educator, I am sure they will be happy to help you find a great class in the Indy area as well. I live and work outside of Indiana, but I was raised near Ft. Wayne. If I can be anymore help to you please let me know. Your fellow Hoosier! http://www.stvincent.org/education/ems/emtcert.htm http://education-portal.com/emt_certification_indiana.html http://degreedirectory.org/articles/EMT_Classes_in_Indiana_Which_Indiana_Schools_Offer_EMT_Certification_and_Training.html Just a few I found with a quick Google search.

I'm really torn about this. I can see both points of view. The actions of this medic did a great deal to squelch the potential danger a pursuit would have definately caused. That being said, I can see how this could also be a liability as well. I guess I am leaning more on the side of the EMT here, but mostly because of the way it turned out. Had it turned out differently, it would be very easy to crucify this medic. He was lucky this time and was able to perform a great public service, but what if he had killed this guy, himself or someone else nearby? You have to admire his tenacity and bravery though. I'm not sure I totally agree with this assessment. I've been in many situations on scene where a patient suddenly becomes combative and I've had to assist in the restraining of that patient, both chemically and with soft restraints. We're definitely not law enforcement and we should try to stay out of those situations whenever possible, but we make those judgment calls routinely, don't we? It isn't always black and white or matter of fact. Obviously no one in authority involved with this case can condone the actions of this medic, but you know that behind close doors they're really thanking him for stopping a bad situation from getting worse. It wasn't like he was going to have to wait for law enforcement to arrive, either. Law enforcement was right behind this guy and the medic knew that. I wasn't there, but from what I've read, it doesn't sound as reckless as everyone against this medic would like to make it sound.

I, for one, think that it would serve us well to go through a little self-defense training. Maybe something like what police academy students go through. We also should be allowed to carry pepper spray or a taser. I worked, for a period of time, in one of the worst parts of a major metropolitan area. The system was set up for police to respond with us on almost all calls, but several times we were instructed by our dispatchers to advise if PD was needed upon our arrival. Well, if PD is needed, after our arrival is not the ideal time. I've been fortunate in all my years of EMS, to not have had to get seriously ugly with a patient or their family/friends. It only takes that one time, though. Having a knowledge of how to react in self-defense can go a long way in giving a person a skill set to defend themselves, provide self-confidence, and to protecting the patient should you have to defend yourself. As for learning something once that you'll never remember...I have to disagree here. We learn things throughout life that we may only be exposed to once in awhile. How many time does a provider do a trach in the field. Sure, it happens, but realistically, how often? Still, they teach us so that in that one time we have a knowledge of it. I'm just saying...an initial class with an annual refresher would probably be sufficient in providing EMS a base for defending themselves. I wanna be careful here to stress that we should always remember that violence is NOT our job. We should defer to law enforcement whenever possible, but sometimes, law enforcement is not there. Have a great day guys.

I'm very actively involved in politics. I'm cool-headed. I still think this is a calm discussion. I just take offense to being told that anything expressed to demonstrate the level of the anger the American people are experiencing as "infantile." This is a very serious matter on so many different levels and requires our full attention. The POTUS was giving a speech today and making fun of all of us who recognize the threat this bill and the manner in which it was passed poses to every single American. It was deeply immature on his part and just continues to rub salt into the deep wounds they've already caused. It's disgusting. He's disgusting.

Hey, I'm not saying I condone the violence. I'm saying that I am angry enough, and I rarely ever get angry, that I can understand it.

Excellent, then you're as angry as most of the rest of the country is. Revolution is not the ONLY answer, but they're not giving us many alternatives. There is no exaggeration in any of this. This is serious and perilous times for us. Obama is the worst president in American history. Congress has the worst approval ratings in American history since polls started being recorded. This isn't a handful of fanatics that are angry...this is the OVERWHELMING majority. Bush didn't actively work to socialize America. Besides...we're not talking about Bush anymore. Bush's time has come and gone. We can't undo anything about the Bush presidency. He needs to stop being everyone's answer to what Obama is doing to destroy this nation. . I think we all do too Funky....the problem is that we're under a regime right now. We have a government that has gone rogue and is acting contrary to the will of the people. We're being violated. Maybe you need to more fully read the posts in this thread. We've all said there are a couple of things in this that don't sound bad. I like that insurance companies will not be able to hold a pre-existing condition against someone. That part of it is deeply overshadowed, however, by the rest of this terrible bill. I'm not cleaning up anything. This government has gone hostile towards the people. I'm advocating the removal of this governing body. I'd prefer it not happen by means of anything violent, but I guess that will be up to them. Violence is rarely ever the answer to anything in life. But sometimes people have to defend themselves, their principles and values. This government has nobody but themselves to blame for the threats they're receiving. They chose to arrogantly blow off the masses.

The crew was not canceled by dispatch. The crew isn't totally to blame here...this was a failure from the top down...All I have maintained is that there is disciplinary action to be handed. When you get to the patient, Tsk, you determine what kind of help you need. You do the best you can. You start to make calls for whatever help you can get, IF you need to. Not going to the patient at all is the failure here.

I don't condone acts of violence, but I'm so frustrated that it is easy to celebrate this. Gotta do something to make these idiots actually represent us and not their own special interests. It was times like this that started the revolutionary war and frankly I think it's time to revolt. What do these guys expect when they act in direct defiance of the will of the people that they're supposed to be representing? The majority spoke in overwhelming numbers and they just flipped us all the bird. I've never been so angry in politics in my whole life and it's going to get worse. Next their going to give amnesty to illegal aliens and take over the banking systems...we HAVE to stop this crap! By the way, Obama has done more damage to this country in one year then Bush did in all his tenure. And, Bush is no longer in power so it's time to stop blaming him. I was no fan of Bush, but Obama is destroying the American way of life.

Key here is, "on the phone." The MD did not assess this patient. It's difficult to DX over the phone. If you could DX over the phone, why would we ever need EMS crews. The fact that this guy called for help, what, three times is a red flag by itself. The fact that his significant other stated on the phone that he was not easily arrousable after falling asleep should have been a HUGE red flag. The fact that they then told them that he was too sick to walk the distance he was asked to walk should have made any reasonable agency/crew get out and go to the patient (which they should have done anyway). This isn't rocket science. It's our job description.

Herbie, If the crew had gotten out and assessed the patient, like they should have done and should be disciplined for not doing, then they could have made the determination as to whether seeking additional help or not was necessary. They had a duty to act, regardless of the situation, and they failed to act. Calls being triaged in the call center are one thing, but once the call has been assigned then you're obligated to act no matter how taxed the system is. People are trying to add all the drama to it. Take away all that drama and ask yourself the basic questions. This is really a simple case of failure to act. All the other stuff in the background is just drama. Yeah, the weather sucked and the system was taxed, but the call was assigned and the crew failed to do their job.