Dustdevil

MA, there was no reason to read anything personal into that. People do that here all the time. They come post a scenario and ask us for input, then they come back and feed us more information as the scenario unfolds. It's actually the norm here, so you can't blame us for thinking it. After all, you DID leave something out, albeit accidentally. We won't know what else you are leaving out unless we ask. Just like the BGL thing, you won't know what you have forgotten unless we ask about it. You posted a beautiful scenario, and obviously did a great assessment. Nobody's attacking you or questioning your competence. We're just trying to get into your scenario.

No Sir. Thank you for recognising my honesty in the spirit in which it was intended! I knew I had not misunderestimated you. It is not at all my intent to attack or degrade you personally. It is very obvious that you are an intelligent and dedicated guy, or I wouldn't still be trying. I wish you the very best of luck with what you are trying to do. And it appears that you do have at least a fundamental grasp of the big picture, so let's move on back to your question. It's a tough situation you are in. There are all sorts of ways to keep up continuing education, even in the sticks. Online educational opportunities abound, so long as you are willing to pay for them and devote the time and effort. But you are right. That doesn't totally compensate for a lack of patient exposure. Especially at the EMT B level. It is actually a little easier at the paramedic level, because the focus is on recognisable scientific concepts, not repetitive monkey skills. But, that kind of non-contact continuing ed is very definitely a start, and something that should not be discounted as useless. Your hospital may even have con ed that you can sit in on. If they have EMTs, then I would bet they have a programme set up for keeping them up to date. Check into it. What about spending time riding with the hospital? What about spending time riding with the nearest big city agency once or twice a month? Although, I have not heard of a hospital based EMS running EMTs since the late 1970s. :? It doesn't sound like they have a lot on the ball, so they may not be your answer either. This is a problem in areas where each and every little rural community has their own vollie service. Nobody ends up with a run volume sufficient to keep current. If the hospital were to step up and provide a serious, multiple unit service, each community could have reasonably close service, full-time paid professionals, and people getting regular experience. If the money each community is spending on their volly service was put into one big pot at the hospital, you could have that. Fragmentation is a major problem, not just in your community, but in EMS as a whole. I am a drummer. I sometimes go years without picking up a pair of sticks. Zero practice for five years at a time. You would think that after five years, I would have a hard time starting to play again, wouldn't you? After all, it's one hell of a lot harder than anything an EMT-B learns. But no. It's no problem at all. Two reasons why: first, because I was serious enough about drumming at one point to devote my full attention and efforts to learning it to the point that it became part of me. And second, because everytime I hear a song on the radio or iPod, I am drumming to that song in my head. No, I am not physically drumming. Just drumming in my mind. I guarantee you that it helps, and helps a great deal. There is nothing so difficult about EMT-B "skills" that physical repetition is necessary for retention. You can do this all in your head if you have the commitment to doing so. So shell out some money for con ed, even if it is only online. Spend a crapload of time on Google researching medical topics. Case studies about heart attacks, pneumonia, diabetes, strokes, hyperventilation, COPD, burns, etc... Come post scenarios here at EMT City and watch everybody work their way through them, then compare that to your own thought processes. Quite honestly, this forum here is the very best continuing ed I have ever found in thirty-four years of practice. Don't get hung up on "skills" and "protocols," and don't get hung up on simple trauma which require nothing but those skills and protocols. Be a thinking man. Focus on medicine, human physiology, and pathology to keep your mind sharp and developing. Aside from memory, there is only one "skill" in EMS that is really important. That is assessment. Focus all your energy there and everything else comes easy. Best of luck!

Squint, you wasted that post, bro. That deserves a thread all of its own.

Ya know... there comes a point to where it's not even worth the effort to find the exploding head graphic anymore. :?

LMAO! I wonder if I could get away with making that my new signature line?

First, nobody slammed you. You're imagining things, probably out of a sense of guilt because your old enough and smart enough to know we are right. And second, you do have control over your personal behaviour. You can do the right thing, regardless of whether everybody else around you does. Mature adults don't keep doing something just because it's fun and everybody else is doing it. They look at the big picture and decide if this is what is best for all concerned, not just themselves. As for us being less than thrilled at your altruistic sacrifice to your community, I notice you haven't bothered to tell us how you would feel if you lost your ability to make a living because nobody was willing to pay for HVAC service anymore. Come on, man. You're smarter than this. This is not a complicated issue. I know you understand exactly what we are talking about. You just don't have the integrity to admit it because you don't want to give up your hobby. Kudos to you for making an honest attempt to be better at your hobby than the average wanker. I respect that. But it's still just a hobby to you, and apparently, that's all you want it to be. Can you honestly not see how people might take offence to that? How about if we told you that we didn't need all that education to fix air conditioners, and that people with 120 hours of night school should be able to open up shop and compete with your business at a fraction of the price? Are you honestly going to tell me you wouldn't show up at the city or state meetings to raise hell about that? Of course you would! Now, tell me this; when was the last time you went to a city/county/state meeting to demand better EMS for your community? What's that you say.... never? But wait... I thought you were concerned about your community! See where I'm going with this? You're not blind to the obvious answer. You're just ignoring it and hoping it will go away and not interfere with your fun. I'm as much about fun as the next guy. But, as a professional, I have a responsibility to be more committed to the profession than to my personal quest for fun. Are you a professional? If so, prove it. If not, are you willing to tell your patients that? And, by the way, plus 5 for an awesome screen name. :wink:

LOL! I hadn't thought about it before you said that, but you're right! I do see a whole lot of those qualities prevailing in the EMS community. :shock: Of course, I would like to see that change.

Okay, Mel, now you are equivocating. You are now asking questions and making accusations that were not included in your original question, which was... You didn't ask anything about who was "smarter," and nobody here has said anything at all about anybody's intelligence. That's a non issue that you have deluded yourself into the middle of through your own insecurities. Your question was black and white. You asked if a medic with two years of education is a better medic than one with nine months of education. Now, if you have a four year science degree (which I do too, in addition to the nursing degree), I'm going to take a risk here and assume that you took at least five semester hours of mathematics, so do the math and tell me how your question adds up to anything other than an emphatic 'yes.' You further attempt to cloud the issues with red herrings about your personal education obtained prior to and since paramedic school. Totally irrelevant to the question you asked. We're comparing apples to apples here. We are not comparing the most uber educated and intelligent 9 month medic to the least educated and intelligent 2 year grad in an attempt to justify fuzzy math with non-objective data. The absolutely indisputable mathematical fact remains that more education equals more knowledge. That is the one and only point being addressed here. You may indeed be an ubermedic, and TEEX may in fact produce teh 4ws0m3 m3d1c in three months. I don't know, and I never claimed to know. What I and others here are doing is asking you fair and objective questions in an attempt to learn if this is the case. So far, all we have gotten in response is a lot of irrelevant cries of "victim" and a phone number to the school's sales manager in an attempt to resist telling us anything of substance. So, apparently, there really is nothing positive to be said about this school, or else you are -- despite all your education -- completely incapable of articulating it. Which is it?

I have to admit that it left me scratching my head for a few minutes of re-reading the thread too. I thought I had missed something. But, what I finally got out of that post was that he was simply comparing the "If we only had ALS" argument to the other poster's argument that, "If she had been in a taxi, she would have needed an ambulance." I think he was just reinforcing the "what if" theory, and not specifically introducing an ALS element to it.

LOL! Okay, it was killing me, so I had to go find out where that quote came from. I remembered that exchange, but couldn't place it. It's the first few posts in this thread from ONE YEAR AND EIGHT MONTHS AGO! At the time, N.S. ACP had a pic of President Bush as his avatar, and I had a pic of Canadian PM Harper as mine. I guess you had to be there. 8)

Correct. Just like a doctor who went to a two-year Caribbean medical school without a complete pre-med education is less of a doctor than the one who went to Harvard. Would you disagree? And I'm not looking for a sales pitch from the programme director. I already earned my diploma. I'm interested in your personal objective and subjective thoughts on the programme and what convinces you that it is the best available in south Texas. After all, if it is that good, and they are doing something that right, that quickly, we should all take a lesson from them, shouldn't we?

Another fine point!

Not only have there been studies, there have been thousands of lives saved in the last thirty years since these hit the mass market. I am one of those saves. You want a study? Come see my x-rays. Yes, these should be required PPE just like gloves and eye protection. Don't wear it? You're fired. Period. Agencies already save a tonne of money on us because, unlike the firemonkeys and cops, we come to work having already payed for our own education. Maybe that works against us. Since they didn't have to invest in our training and education, maybe they don't feel the need to protect us as much as the public safety guys. It's bad enough that people outside of EMS have no clue about the dangers we face, but everytime some complete idiot of an EMT or medic asks me why I wear a vest, I honestly want to intubate their face with my boot. Especially the fucktards who think they only need to wear it on known violence runs, over their uniform, nonetheless. Seriously, if I ever heard an employee of mine saying something so totally retarded, I'd fire them on the spot and replace them with the next 20 year old rookie that came along. They simply aren't smart enough to be entrusted with human lives. No worries though. Nobody that lame will ever make it through my hiring and orientation. :twisted:

What about a 12-lead? Unlike the IV, pretty much everybody cooperates with that. And it takes no more time than the IV. Do you wait for it? And good for you for thinking above and beyond your protocols. :thumbright:

:shock: Dude, are you having flashbacks, or what? The last four avatars in this thread are Burt Reynolds, Bubbles, Yoda, and an Imperial Storm Trooper, so I'm afraid to even ask wtf you are talking about.

Just in case it is lost in the subtle, sarcastic humour, I want to make sure you see the very important point that our friend of few words was attempting to make. That is, there is a cause and effect relationship between volunteer EMS and the inability to make a living. Think about it; if we moved into your community and started giving HVAC service away for free because of our concern for our community (after all, we don't want them to die of heat stroke or frostbite, do we?), how long do you think you could continue to make a living at your current profession? Not long, I assure you. Bingo! There it is! The reason your community will not pay for EMS is because, thanks to you, they have it for free. I'm sure you can figure out the rest of the story from there. Again, good luck!

Greetings, JB! I saved my 7000th post especially for you! I submit that you are not providing for them as it is. If you and all the other vollies disappeared today, they'd have professional EMS in there within a week. Despite your honourable intentions, you're really not providing. You're actually obstructing. So you're not interested in actually being a professional EMS provider then? You just want a way to help your community? I'd be happy to provide you with a long list of ways to effectively do that without depriving the people you think you are helping of professional medical care. To start with, you could maintain the a/c at the courthouse, jail, city hall, community centre, and schools all for free? That'd be a good start. In fact, I bet with all the money they save through that act of true concern for your community, they could afford to hire a professional paramedic and put this whole question to rest. Hell, maybe they'd even pay to send you to be that paramedic as a reward for your selfless community spirit! Being a professional is not something you just wish for. The National Registry fairy isn't going to leave a paramedic diploma under your pillow some night. You have to make it happen through true desire, personal commitment, dedication, sacrifice, and damn hard work for a damn long time. If that is what you want, then there are a lot of us here to encourage and cheer you on. We'd love to see it. Coming here and openly looking for ways to stay sharp is a very good sign. We can all respect that. It's hard. But that's the point. EMS is not an easy game. And there are no easy shortcuts to being a professional. If you are not totally committed, then don't do your community the disservice of half-arsing it. Go big or go home. Good luck, bro!

And don't forget the CCEMTP. We've had some pretty painful belly laughts over that one too!

Not that he needs me to speak for him, but I'll tell you what he knows. He knows that the time it took him to become an RPN is four times more than what it took for most medics in the U.S. to finish medic school. He knows that the education he has from PCP school in Ontario by itself is more than ninety percent of all paramedics in the U.S. will ever achieve. He knows that his combined RPN and ACP education adds up to about three more years than the vast majority of all CCEMTPs and RNs in this country ever achieve. And he knows that just about every U.S. medic that tries to take his mad skillz north of the border gets laughed out on his fat, uneducated arse. How dare you impugn his knowledge. :wink:

And thirty minutes later, a different transfer car from a different ambulance company showed up and took her back home, like you were supposed to. That post should be moved to the, "Things that make you go 'wtf'" topic.

That's what I'm talkin about, right there! =D> Thank you, Steve! That is what I mean by evaluating all of the relevant factors, and then -- only after doing so -- discussing the implications of the issue intelligently. Excellent job. And I have come to expect nothing less from you. I'm not asking anybody to make the quantum leap to believing that this is something that is appropriate for their system, or for EMS in general. Steve didn't. And, as he made clear, our current educational system is decades (if not forever) away from even coming close to being even minimally adequate to start pushing this kind of practice to the masses. But simple common sense should be enough for anybody who calls themselves a medical professional to conclude that this is indeed very useful information, and that in a system vastly different than your own, there is that possibility that it transforms from more than just "nice to know," to a necessity for prudent and intelligent medical practice.

Simple; if and when this patient is going to deliver. Both are extremely, extremely important factors. In fact, they are the only reason you are transporting in the first place. If you are going to commit to two hours with this patient, don't you think it would be the least bit beneficial to know those two things? Is there not a medically significant difference between true and false labour that makes that knowledge important to the medical professional caring for them for the next two hours? You bet your arse there is! It makes all the difference in the world, especially in a pre-term mother. If this is a normal, primip in early labour who has not even begun to efface yet, you're in for a leisurely ride. If this is a full-term multiparous mom who is dilating, then you can bust the OB kit open with confidence. But if this is a thirty-two weeker in true labour, you damn sure want to know that as soon as possible, because you have some major preparations to start making. I can guarantee you that the hospital wants to know that too, because they are going to want to have an airborne neonatal team to meet you at the door, and that takes time to to assemble. Yes, I know this is not standard, urban firemonkey, ten minute transport, 90 day medic school, DOT minimum curriculum fare we are talking about. Nobody ever implied that it was. But the fact is that the human body follows no protocols. It does it's own thing, and only on a semi-predictable basis. If there is one thing that is predictable in medicine, it is unpredictability. Expect the unexpected. The only to do that is to be aware of the potential of the unexpected, and to actively rule it out. You don't do that by waiting for crowning. How would you handle this transport anyhow? Sit at the foot of the cot and stare at your patient's vagina for two to three hours? I'd like to see that! But, if you have no idea what is going on behind door number 1, then that's really about your only choice. Not me. I have better, more professional options. It's just extremely sad that we are not educating our people to even consider those options, much less understand them. The very best thing about EMT City is that medics from so many different backgrounds come together to discuss a common theme. Therefore, we are exposed to so many different, and potentially great ideas that we would have never thought of while secluded in our own little system, where nothing ever changes. But to benefit from this, we simply must have the ability to think progressively and open-mindedly, considering the diversity of our patients and the diversity of our systems. We can't get stuck on this nonsense about, "well, we don't have to worry about that in downtown Los Angeles," or "my protocols don't allow that," or "that's out of my scope of practice," or worst of all, "I don't need to know that." That mentality is the reason that EMS is still living in 1972. Think outside the box, people! EMS is not about your personal protocols. It's about medicine! Get an EDUCATION, not just more "training" and cards for your wallet. Despite what your school taught you, it is not enough to know that there are 206 bones in the body, yet not be taught the names of even ten percent of them. You need to know all of them! You need to know about the physical properties and chemical functions of those bones, the names of their parts, and the names of the parts that connect to them. The best paramedic school in this country still barely scratches the surface of what anybody who calls themselves a "medical professional" should know. If your school was less than two years long, and required no scientific prerequisites, then you're screwed from the beginning. You start off way behind the 8-ball. And, unfortunately, the vast majority of you will never go any farther than that. I'm no super-medic. And the only significant OB training I even have is in medic and nursing school clinicals. But instead of just standing around and watching during those clinicals, I engaged my brain and soaked up some medically significant knowledge that applies to my paramedic practice. You can too! ... he was just a couple of linear thoughts away from seeing the light. Pretty impressive for a student who has yet to spent his first paid day on an ambulance. So, no offence or impugning intended, Bro. We just have a tradition here of subtly pointing people towards the answers to their own questions without force feeding them to them, because the knowledge acquired that way lasts longer.

I didn't hear them give his name to the reporter. But, then again, the speakers suck on this computer, so they may have. To me it sounded like they were telling the reporter something else, maybe like, "You'll have to get that from the report at HQ" or something. But yes, it is perfectly allowed here, unless the suspect is a juvenille. Even then, it still happens frequently.

So then, you believe that all it takes to be a "pretty damn good medic" is just the minimum amount of hours the state will let you get by with? All those two year programmes are a waste of time, because we don't need all that book learnin? You yourself said that the programme in question was "not that bad," so you can't possibly be surprised that we're a little sceptical about the quality, and about what your personal definition of quality is. You also said that, in your opinion, it was the best school in the south Texas area, so there must be something awful special about it. I would like to hear more about it. I haven't been there. I don't know anybody who has, so I have no preconceived notions. But you can't just toss those kind of claims out there and not expect people to want more information about it.