uglyEMT

I stop by from time to time to look around.

Ruff just beat me too it. In my response area the PD has Narcan in prefilled syringes for nasal administration. So far since implementation it has been credited with over 500 saves. Their training was a 1,ONE, hour course before shift. In my area, anyway, it is as easy as an EpiPen. We let children self administer EpiPens do we not? Now if we are talking about moving beyond prefilled and going into actual draws then no I do not think EMT's should be doing it unless their training includes IV med administration.

Thanks Island. Yes it is a short course with a ton of things. I was glad they give you the material ahead of time, I was able to start getting into it before actual class time. The class time itself was brutal we were going from 8am to 10pm or 11pm at night every night except the night before the boards. They let us out early to study. I will say I learned a ton of things in that amount of time that I don't think I would have ever been exposed to otherwise. It will make be a better provider because of it. I started working at my Dive job over the weekend so I am already putting it to good use.

Hey everyone. Well I did it. Past my Boards. Talk about a rough class. Tons of physics involved, forgot about all that math LOL Then you through in gas laws and saturation tables. Then to make things interesting lets get into mixed gas and partial pressures. Took some time to find my groove with learning it all but once I did it started to come together. After the written exam I was on pins and needles waiting to hear. Finally I have heard and I made it. Thanks to all of those that helped me along the way. Those that pushed me towards this goal I am forever in your debt. I will wear this new hat with pride and make my fellow Brothers and Sisters proud.

Don't think I have heard of IV alcohol use but I would assume it would be the same metabolism as "butt chugging". In that the toxicity spikes real quick and the crash seems harder. I say seems because of observation, nothing scientific. I have witnessed a patient start the withdrawal process within a short time span vs hours. As for the opiod abuse my area has gotten so bad now that we have Narcan IN injectors given to LEOs and stock them on BLS rigs. It is a serious explosion around here and it is worrisome, especially seeing some of the ages of patients. Most of it stemmed from Rx abuse like island said. Then the addiction got to a point that they couldn't afford the Rx they turned to heroin. To add insult to injury this area has one of the purest kinds(according to LEOs) so the incidents of OD are climbing through the roof.

Hey everyone. You wanted to stay updated so I figured now would be a good time to start. Well so far nothing much has happened yet. We did get our course material, forgot how many books are involved in courses LOL, and got some paperwork taken care of. Syllabus will be given in a few days according to the proctors. So far just some preliminary schedule info, 8 to 5 then dinner then ACLS afterwards so my plate will be pretty full. Dive chamber training and practicals are on days 2 and 3 so for anyone flying there will be no issues. That's about it so far. As for the course materials. Wow. A lot to get through that's for sure. I do have a few weeks to study before class even starts but it will still be a lot. Some of the stuff I will really have to get my head around because I never used the information previously so it may take some getting used too. The ACLS stuff I think I need to shake the cobwebs out because I keep getting confused for some reason. I will get through it, just need to sit down and grind at it one day. Now for some questions to you all to maybe help me along. Anyone have a good way of remembering the pharmacology? I have it on cards but can't seem to retain it well enough. Also any tips or tricks for IV and intubation? Hopefully I don't make you crazy with asking a questions.

COA = Course of Action maybe?? It fits though. COG = Cognitive I am assuming SMR = Spinal Motion Restriction otherwise know as Spinal Immobilization, again I assume Never liked acronyms unless they are widely know such as c/o, w/o, PEARL, LOC, IV, IM, IN, ect ect. The time saved is easily lost in translation such as in this case. In this case I would be checking the ABC's first and foremost (action based on findings) then asking witnesses to find out just what the hell happened, if witnessed that is. Without the witnesses I would be looking for possible fall points, such as ladders or ledges. Without those present I would assume a standing fall and take appropriate action based on my trauma assessment. Now based on my protocols we would be boarding and collaring (don't you love places without spinal clearing protocols) and I would get an airway going if necessary or possible. From this point on it will all be based on my findings same goes for transport.

Yea Ruff up around these parts is damn scary what little goes into getting your card. it went from 150 hrs to 200 and those 50 extra hrs were to teach BGL and aspirin admin(and trust me it was drama to add them) then you had 10 hrs of ride time OR 10 hrs in an ED. And still, Finney not saying you here, folks are still bitching about how long and hard the course is, how it will mean less providers, and it shouldn't be required to do all that. (3 nights a week, 4 hrs a night, 17 weeks) As my instructor said at graduation, "Congratulations, you now know enough to kill a person." That's my biggest beef about the lowest common denominator style of training. We should be pushing for longer courses not pandering to the those which do not like hard work. This isn't something you should be doing on a whim or to "look good" on a resume. Our screw up can drastically change lives. At least the places I have worked had long probationary periods before letting folks loose on the public, can't say that's every where though.

It is also a good video showing folks what a flash over looks like and how fast fire propagates.

Well NJ adopted the same requirements last year and do 210 hr courses. The rural volly agencies (yes NJ has rural areas akin to Upstate) made a stink about the added time, cost, yada yada. Nothing happened! Ranks didn't drop except for the folks that didn't want to recert under the new guidlines. The classes are usually booked up when checking the website so new EMT's are certainly happening. Most first time EMT's do not have the option of non classroom learning. After you are certified there are online CEU's available. The whole dropping ranks thing is because those EMT's don't want change and are looking for excuses to keep EMS in the dark ages. Same happened when they required two EMTs on a rig (vs one emt one driver). People don't like change, especially in the Volly world. I still can't understand why folks get upset when hearing courses are only 200 hrs? Guess what, you have it easy and it should not be that way!!! hell hairdressers go through 4 to 5 hundred hours and all they do is cut your hair. They mess up, you have a bad hair week. We mess up you die! But until this mentality of using the lowest common denominator is broken 200 or less hour courses will continue and people will bitch about it being to long or hard.

Welcome

Island she is doing great. Thanks for asking. Amazing little thing, she already has me around her finger hehe Ruff. Shhhhh don't want to scare away any future partners lol

Eyegor not a problem. I hope to do a good write up as I go through or at least once I finish. I also think ti will be interesting. Also I have my local group of divers eager to hear about the course and want a write up but looking at it the other way, as a diver being helped so they can understand what may be required of them in an emergency.

Hey chbare. I'm good on my gas laws as far as dive planning goes. I have been getting more in depth as I prep for my upcoming course. I do know they will be getting into it more through out the course as it pertains to what we are doing. Some of the correspondences I have had said they are very hands on vs regurgitation so we can understand the why as well as the what. I will be updating as the course goes on but for now I am just doing some prep work on a few things to refresh myself.

Thanks Ruff. Yea when I was approached about it after Rescue Diver cert I didn't know what to think so I started some research and seemed a perfect fit for me. Then I forgot about until this week when DAN contacted me and said a spot opened up in their Philly class. So I jumped at it. Should really be an intense and interesting course. I am really looking forward to the chamber time. One of the lessons will be nitrogen narcosis. They are actually going to make us experience it in the chamber so we know our limits, what it feels like, and how to spot it easier. Hopefully they let me GoPro it. Think it will be hilarious. I'll let you know about the dinner. Pretty fimiliar with the area and surround so maybe meet half way. I'll look at the schedule once I get my packet. Now for me to crack some books and learn my ACLS and some tips for the invasive stuff. Don't want to go in totally blind.

Well the purpose of this post is to inform everyone that in May I am going to go for my DMT (Diver Medical Technician) Certification. I will be taking it at the DAN in Philadelphia and at the University Hospital of PA. Can't wait to bridge the two worlds together. For those that may not know what DMTs are here is some information. Instead of paraphrasing I will let DAN explain it in their own words. Quote So besides my normal BLS studies I will be adding some ALS skills. Yes, before folks ask, this does NOT qualify me to be ALS in the medical field, I checked. The AHA ACLS is recognized Nationally BUT being I will not be a recognized Paramedic I will only be able to do these skills in a diving environment not during my EMT shifts. Yes, I will be with online medical control through DAN during invasive procedures as per guide lines. I also get to work as a chamber tender which sounds interesting as well. Might even open a few doors for future employment. Looks like I will be bending some ears as I go through this course to help with the invasive stuff if I can't grasp it right away. Thanks in advance to anyone who helps out Well figured I would give folks a heads up in case they get weird PMs from me.

I think most of us seasoned folks would follow suit. Its the ones looking for pats on the back or high fives that would dive in and announce to the world their level of certification. Yes if its critical I will jump in, and I have, but unless it is time sensitive (choking, arrest, arterial bleed,ect) its basic first aid or just a phone call. One exception I do make only because of the roads I travel is MVAs. If its more then a fender bender I usually stop and at least ask if everyone is OK.

Was I the only person wondering if this happened in the morning? Surprised I haven't seen the nurse make the rounds in those "incredibly photogenic" memes. Finally after all that my brain switched to... how?

According to my local protocols once the condition changes the RMA becomes void. Document document document. I, personally, don't like that rule. As Ruff said what changed besides his LOC? If he was AMS then we wouldn't even be discussing this because of implied consent being the proper protocol. If he was A&O enough for us to accept the refusal then he was competent enough to have his wishes honored. I would like to respect the patient's wishes but alas as stated above that's not allowed in my local area. As far as honoring it as a DNR, again unfortunately my hands are tied unless I see the State approved signed by patient, physician, and two witness document I am required to treat to the best of my capabilities no matter the situation. I did have a call where we had a terminal patient but because in the chaos of the moment the family couldn't produce the document and we had to treat. To me that was akin to torture both for the patient and the family. Thankfully the family was able to produce it by the time we got to the hospital and I heard the ER physician honored it. So again if the patient refuses and becomes unconscious I have to treat. In my mind I would like to honor the patients wishes fully if I get their consent in a manner that I feel is supportive of competent mental status. I don't presume to know why someone wishes no interventions even if the prognosis is death. When I hear in the Oath "Do no harm" I take that as being absolute. If by me intervening against the wishes of the patient prolongs their suffering (mental or physical) then I am doing harm and thus breaking the oath. I know that's a very literal interpretation but for some reason I feel that way and it sits well with my conscience.

Good article. Even the program sounds good, thanks for letting me know about it. I know for me when my father was paralyzed (quad) and finally came home the first thing I did was call the local ambulance, fire and PD to notify them of my father. I also notified them if they responded and received no answer at the door what to do. From time to time if something changes I will update them accordingly. Their community doesn't have a program in place. Thankfully the few times they were required the appropriate man power and resources arrived. Also during Sandy the local PD did welfare checks and even brought over 10 gallons of gas for the generator. (sorry for the side track there) I think these kind of programs should be all over, I even like them including developmental disabilities to the list. I think it would benefit any agency that serves their community. I know a few years ago we helped get the Life Tube into our community and it has made a difference so I could see this helping as well.

Never too early Actually gives me a great idea for an outfit Thanks everyone. I will put up a few more pics in a day or two. Right now I'm digging out from close to two feet of snow.

All I can think of every time I hear this story is Achmed The Dead Terrorist and Jeff Dunham. I Kill You :D KEH

Hey everyone. Haven't been around for a few weeks. We had our first child Now I'm a proud Daddy to a beautiful healthy baby girl She was born January 2nd (I know missed it by one day LOL) and since then my life has revolved around her. Every chance I get i just want to be holding her or watching her. Needless to say the internet took a break. Now I am back into the routine of working and life in general, was a nice little vacation. So without further a due... Please welcome Teresa http://www.emtcity.com/gallery/image/886-teresa/

The worst time I got asked that question was during one of my recerts by an IFT guy. Half the people in class gave him a WTF look and I just told him to... well you know. I know my family at first asked about my calls that day but after a few times it turned from asking to just inquiring if I am doing OK. The only time I retold a story was for a teaching moment in a civilian CPR class after the instructor was sugar coating CPR to the class making it seem like if you do CPR, ask for an AED and pump 100 times a minute the person will live. I left out a lot but got the point across that its not always roses, most of the time you are just delaying the inevitable. I like the idea of the burned foot and just telling them to hug their kids. Might try that one.