uglyEMT

Hi and welcome to The City. Basically you have to start at the bottom. Take an EMT course in Portland, or wherever you will reside. Its 120hrs of class time and a test. This gets you your Basic certification. After your basic you can apply for paramedic school and then its alot of class time (years I believe, I am not a medic) followed by ride time. I would say this, it is my personal opinion so take it as you wish, I wouldn't go from basic to medic quickly. I would be a basic for a while and learn. Gain experience in the field. Become comfortable with yourself and patients. The hands on experience is invaluable, without interaction its just modality. Most medics I know have been basics for a few years to gain this experience and they are great medics. Hope this helps some for you.

Its OK Herbie. I cope and around this time of year it helps to talk about it. Keeps everything from getting bottled up. I do suffer PTSD and have gotten treatment for it. Talking is a big help. I was there that day on the 10th floor for a job requirement. There was a goverment office there that I had to interview at for a security clearence. Thatw as my only reason to be there that day. As for staying on "The Pile". For some reason i felt I had to be there. In the first moments after the towers fell alot of folks just started looking around trying to find people and help in any way they could. I was not a responder at the time, I had no training in rescue, nothing. I was just a pair of hands, eyes and ears trying to help. I got on a bucket brigade with the Jersey City Fire Dept and just passed buckets of debris. Time just stood still I didnt realize how much time had passed between shifts or what evere you wanted to call them. Things I did see I dont want to ever see again. Some things of that day I just dont remeber. I have tried but they are just not memories I have. It was after therapy to get me over things that I started looking into EMS as a field. The strong urge I felt that day to help others always stayed with me. Its not THE reason I became an EMT but an underlying one.

Im not endorcing a product here or being paid in any way... 5.11 ATAC Boot!! I have booth the 8" side zip and the 6" station version I wear the 8" as a duty boot and the 6" is my daily everyday wear. VERY comfortable. They are oil and BBP resistant, anti slip, have a composite toe (not steel, carbon fiber), can take a shine if needed, water resistant (I never say proof unless its a yellow rain boot LOL) and comfortable.

Sorry for getting to this topic so late. I was on hiatus and just got back to technology. Where was I on 9/11..... 10th floor Tower 2 What did I hear..... Boom, screams, crying, sorrow What did I do.... Helped get folks out, cryed like a baby when I watched them fall. Looked grey and so did everyone else there, cryed some more. Climed the pile and started helping. Sirens sounding, run... 7 falls Back to the pile...... 72 hours later after seeing unimaginable things I finally brake down and cry into some girls arms volunteering with the effort. Do not ever want to see what I saw there again. I watched strong, heroic grown men do the same. One thing that will never leave me.... when we all turned greey as ash and the world looked like the moon, we were all one. No creed, No color, No religon, Just ONE. I hope one day we can all get back to that place.

I agree!! +1 I am the same way all my documents are in plain english. I do like using certain accronyms or abbreviations only when communicating to the ED with a patient beside me. I dont want to tell the ED I am inbound with a emotionally disturbed person while that person can hear me and might react to it. Tell the ED I am inbound with a XXyear old M/F EDP ect sounds alot better than XXyear old M/F being emotionally disturbed. Thats all. 10 codes are going the way of the dodo and slowly we will see plain english in radio coms. My service area is mixed. Some say what they say others sound like an algebra problem. My favorite over the radio is unit XX can you 10-21 for a 62 during 7 (can you give me a call for a report during your break) LOL

our local protocol is as follows for that Notify ED of person showing s&s of emotional distress without other factors as EDP so proper measures are in place upon arrivial. Notify ED of person showing s&s of emotional distress with other factors (ie ETOH, drugs, head injury) as AMS so proper measures are in place upon arrivial. Normally in or PCR we use discriptive wording vs saying AMS or EDP thus not diagnosing a patient but describing our observations. The only time we will write AMS or EDP is if it is a prediagnosed condition. AMS will be used for head injury victims on our PCR is that is a finding. Basically a good way the OP can find normally used abriviations is to get an EMS field guide. In the back are commonly used abriv. that are universally recognised. One thing is though, as my crew cheif always says, its better to spell out what your saying because you may know what you mean but 12 people not smart enough to get out of jury duty may not. here is a link to a PDF showing commonly used EMS abbriviations Link Note on link: its is based out of Northern California so they have an additional page of hospital abbrivations that would not be used outside their service area. Hope this helps

The thing with this guy is they took the camera into evidence pending a charge of impersonating a emergency worker. They wanted to check if he took pictures of the deceased and if he was in the way. Also at ther scene he was in full turnout gear with helmet. It did say photgrapher on the helmet though. The photos were taking from over 75 feet away with a telephoto lens so he was not in the way. He is a photgrapher for First Responder News with credentials. Also he states he was asked to be a dept photographer for the local EMS but their chief denies it. EMS News.com

Thanks Dave. I stay away from the meds side being a BLS provider but at least I know I have my ABCs in order. Thanks! Copy on the cardiogenic shock. Thats a new one to me, I had to look it up. Thanks for giving the answer as to the low BP. Its something I will look out for now. As for the frothy sputum Im asuming that was caused by the blood backing up the pulminary artery due to the decreased heart function.

I too, as faking stated, am in the prespective of being the student. Im the rookie in my squad (lol 30 something rookie no less) and have had a few teachers along the way. I had the gruff teacher, jumped all over me at every turn if it didnt do it "their" way. Made me feel less of an EMT, like I wasnt good enough. Especially if it was done around a patient or their family memebers. I had a laid back teacher. Kind of a go with the flow man teacher. Well Im just glad I didnt kill anyone. I had a teacher that let me go about the call the way I wanted but lent a hand if needed. This is and was my best teacher. To this day I learn from this person. When we run calls together I have confidence in myself and it shows. My moves are deliberate, consice, nothing wasted. I have a confident, not arrogant, tone with my questions. My hands feel more, my ears hear more. It is because as I was learning I got to teach myself but with the reassurance that if it was going downhill I had a partner that would step in and help. I had slip ups but wasnt talked about until after the call. That I liked, I wasnt embarresed. I was able to realize what went wrong and why without a spotlight on me. One thing I will say, I dont know if it goes for everyone, dont call your rookie a rookie, newbie, greenhorn, fresh emt, what-have-you during a call. I had some teachers that would let everyone know I was new and it hurt actually. It made folks turn away from me and talk to my partner instead. That never helped. If you talk on scene talk like the two of you have worked years together. I used to tell folks after my feathers got ruffled enough... It says EMT on both our sleeves noone knows rank or experience. Basically all anyone sees is that we are both the same as far as they know, why let them think anything else. Its their emergency the last thing that want is someone, they feel, cant do the job. Even though this rookie may be the best in the business if you call him out on the job (scene) the preception is he cant do anything other than be a go-for. Good luck in your teaching and hopefully you can get through to him. If not, use it as your learning experience and move on to the next. Some folks just dont mesh well with one another.

This almost sounds like what my father went through recently... OK BP is falling but rate is up sounds like hypovoliemic. Push fluids start with 2 units saline. If possible check with hospital to see what, if any, vasodialators he was given. Check to see if they would react to his precription meds. If hes had this kind of history the meds would be in his system long after 24hrs. Might be looking at a reaction and severe vasodialation which due to his weakend heart is making the volume drop thus the low BP and s&s of shock (note he hasnt lost blood but doesnt pump enough through the system to maintain healthy BP) The frothy sputem in the tube sounds like a PE. Could be a result of the procedure. The "shock" he felt on the ride home could be indicitive of a arythmia caused by the developing PE. From my BLS experience I would say suction, get the fluids going to get the BP up, notify receving facility of updates, major diesil bolus.

I was too Richard. What we are coming to the conclusion of is the nursing orders were unclear as to when to give the meds. Most of the charts, from what I caught a glimpse of, showed XXX med 2 times daily. So without definitive orders such as only if BP is above XX then the nurses gave the meds at one time. Spellings might be off so bear with me Coreg Imdor Plavix Crestor Asprin Heprin Dilaoton Morphine Percicet Basically what was supposed to happen according to the docs. Imdor and Plavix post op 48 hrs morphine for pain 2 times daily if needed. Coreg and Crestor 2 times daily after 24 hrs with just asprin to clean out system of previous meds then maintain those two until necessary. Percicet back to pre op dose after 1 week. Morphine while in post op only. Dont know where the Dilaton came from. Also what the hell were they giving him Heprin for??? When he crashed Tuesday again blood work showed all above mentioned meds in his system at daily levels. The charts seem to show the meds never being removed from the previous days chart just added to. So right now we dont know why but we know how it happened as far as the bottoming out. We are just glad the problem was caught and rectified Wednesday after a thourough review of his charts by multiple dept heads. The head of cardiology that did Dad's original procedure actually called them all in because and I quote, " I have too much invested in this patient to quit now." As far as other hospitals. Mom and Dad have decided they will come back close to home in NJ at a local sub-acute care facility he was at once before. Then home. He has been through too much right now and we just want him strong again and back in his home. So thats the skinny on whats been going on.

I know he has not taken any meds since yesterday. Was any of his meds an expectorant? Wet cough with COPD and CHF sounds like a fluid buildup. The 88 on 15 is telling me alot of fluid. Time for CPAP. Vitals indicate elevated HR but with a pacemaker it should be regulated. Ask wife for the card to see the max and min of the unit settings. The 60 on the BP does seem low considering the age and hx. Vasodialation may be caused by the low O2 levels. One thing I would say is get the Sp levels UP he cant keep the 38 breaths up for long. CPAP and call med control for instructions on meds. After getting the O2 levels up recheck BP and see if it has come up and HR has come down. I feel the BP and HR are being caused by the low O2. Im only BLS so the meds I dont know what to administer thus the call med control. I have a few guesses on the underlying cause besides the fluid Being he hasnt taken anything by mouth in a day and is diabetic could we be seeing dehydration with an insulin buildup thus leading to the tiredness, dyaforetic pale skin?

A NY Post article states that the persons wanting to build this mosque will possibly get funds from Iran. This is turning into a shyt storm in a huge way. What happens if its funded by them? Does this act as a game changer? I dont know enough to comment either way. Do I think its right? On the fence. Do I want to see it happen? No. With all the places available to them I think this location is just asking for trouble. I can see the protests, violence, crimes now that would arise if this is placed where it is. One thing that does strike me is this... the folks wanting to build seem hell bend on putting it here almost to the point of rejecting everything that would scare a normal developer away. Seems there is an agenda behind the scenes and that I do not like.

Hey Folks, me again. Another update. Well as you can see some time has past since I last posted here. Well it was for a good reason. Dad had complications. A few days after my last post in the thread Dad was released and came home. I stopped by the next day just to check on him and was astonished what I saw. He looked like crap, I went to my truck and grabbed my bag. Checked BP 50/40, pulse 75, resp 16. Skin dyaphoretic. Dialled 911 and got things moving. Being they do not live in NYC he went their local ED. Took 4 units and rushed for tests. CT, MRI, Echo. Well it was the echo that astonished us all. A load of blood in the pericardial sac. 750cc to be exact!! Docs sucked it out and prepared for a pericardial window. Mt Sinai was advised and said send him there. He was transfered to Mt Sinai and they ran their tests. The bleed was stoped so they decided to monitor instead of surgery. After 24hrs they felt he was in the clear. He spent several days in CCU. During this time it was decided he would need acute care after recovery so plans were made. Monday he was transfered to KCC which is Mt Sinai's acute care center. Well Tuesday he crashed again. Unresponsive BP 63/48 but breathing. Took 2 more units this time saline and BP came back up. Wednesday docs were scrambling to figure out what the hell was going on. Well last night we finally got the answer.... too many meds!!! Seemed like every doc added something to the chart and what not. Had so many vaso dialators in his system his volume couldnt keep up!! Hes back in KCC now and doing well again (keeping my fingers crossed). This time with his meds closely monitored through blood work and inroom checkups. It has been a roller coaster of a ride here. I went back on duty tuesday and wednesday and it felt good. Since Dad has been in I have been on a LOA so felt good to put the uniform on. Was actually funny, Tuesday was a core 12 drill so it was like the EMS stars aligned and wanted me back. Got some CEUs and a nice refresher to clear the cob webs. I am feeling good here, less unconfident. I was second guessing myself there for a while. I guess we do that when its a loved one. Thankfully my squad, my wife and you folks have been helping me get through this tough time. It makes me feel good to know I have a good support system that I can rely on when needed. We really are one big family. I will keep you all updated when I can.

Bilderburg The whole NWO geoecopolitical machine is how it happens.

Just my personal opinion I would say go with the service that has the higher call volume. If all things are equal otherwise (benefits, vacation, ect) the experience from the call volume will be great. I personally work in a service with extremely low call volume 1 or 2 a week basically and the lack of experience is litterly mind numbing. Also I would consider in the pros and cons the other employees. These will be the folks you will be working with. Do they rotate crews or once assigned you're with them always. I would rather be with the same crew that way after awhile you and your partner(s) flow and dont need much interaction to know what the other needs or is doing. I work in this manner, same partners going on 2 years now. Each knows their roll and we dont need much communication to get things done. Also we know which calls each other are strongest on and rotate duties accordingly. It seems to others outside the community that we are not talking or look mad but its just concintration and that second hand feel to our personal dynamics during a call. In the end it will be your decision and you'll make the right call. Congrats on the new job BTW