Dustdevil

Think very carefully about the situation we are discussing here. 1. Patient experiences chest pain 2. Patient calls for EMS 3. EMT-B or lower arrives 4. Patient has NTG that he has not already taken before your arrival 5. Patient is stable enough to administer NTG to Folks, this is the proverbial zebra. It's one of those very rare situations that EMT-Bs lay in bed at night and have a good toss over, but in reality, it just doesn't happen often. When people with diagnosed angina have chest pain, they take their NTG. If it doesn't work, they take it again. This all happens long before any EMTs show up. If they didn't take their NTG, either they don't have it, or else they are disoriented, meaning their vital signs are incompatible with NTG administration. Not that this stops most EMT-Bs from giving it anyhow. So, one day you actually stumble across one of these zebras, and you immediately pop wood. You squirt your... uh, I mean his NTG under his tongue and think to yourself, "Wow! This is SO cool and SO easy! It's stupid that paramedics think they're the only ones that should do it!" Less than sixty seconds later, your patient goes from a pretty pink to a ashen grey-white colour that you will never, ever in your life forget. He quickly becomes almost completely unconscious. His blood pressure drops too low for you to even palpate. And, to make the experience even more memorable for you, he shits his pants in grand style. You will too, as you see your career pass before your eyes and wonder how you're going to afford the attorney to defend you, even if your patient lives. An IV makes absolutely no difference whatsoever in the above scenario. So then, what do I want to see from any EMT-Bs that are unlucky enough to have been dispatched on such a run in the first place? Nothing but the tail lights.

Neither was I. I didn't say anything about Basics or Paramedics or who should or should not be administering anything. I just stated an undebatable fact: Administration of a prescription drug, requiring the order of a physician, is ADVANCED Life Support. This is the BASIC Life Support forum. How difficult is that to comprehend? Yes. But what does that have to do with anything that I said? English comprehension goes a long way folks. Oh, that's right... you don't need all that book learnin to be a wanker.

Best reason in the world to completely forget about EMS as a career, at least for now. Over two years of school to get started. Your kid will be over a year old by then. The pay is horrible and the hours are too. You'll miss a lot of family time. Then another two years at a minimum to do nursing school. And once you finish nursing school (actually, most medics who try never finish nursing school), you'll seriously kick yourself for having wasted any time on EMT and paramedic school, which is not the least bit helpful to your nursing pursuit. Especially if your marriage ended because of it, which is pretty common. Sounds like you need a job, any job paying better than minimum wage, and quickly, not in two years. Do that and get through this kid thing first. Then pick either EMS or nursing and focuse entirely on whichever you choose. Going back and doing EMS after nursing is smart. Going back and doing nursing after EMS -- when you were told ahead of time not to -- is stupid, and a self-destructive recipe for failure. Don't sabotage yourself from the get-go. And I have no idea what an "ROP class" is.

Your patient's "confidentiality" was not even remotely an issue. I'm not sure where you even get that idea. If it were, we'd be covering up every patient at every scene and running through redlights. We don't. Cops don't run EMS, and don't let them try. If they want me to run a red light, fight the media, or anything else, they can get bent. Not my job. And not their job to tell me how to do my job.

You will get no relevant answers to these questions until you tell us exactly where you are. Sorry, but each one of those questions is entirely dependent on where you are and who you work for. There is no "normal" in EMS. And, of course, each of those three questions are the most over-discussed issues on this forum. Slow down. Find the search function. Take a look around. Fifteen minutes here and you will learn a whole lot. And welcome!

Yep. There it is. Jack Stout's putrid legacy. The service is a governmental agency. AMR is only a contractor providing a service to that agency. AMR is not the big enemy here. The government agency employs them because they WANT somebody who will do it cheaply without the county looking like the bad guys. It's just like WalMart contracting with a company to clean their floors for them. The contractor utilises wetbacks to do the work, and WalMart knows it. But if somebody makes an issue of it, WalMart just says, "Hey, it's not us! It's the contractor!" So anybody who thinks the government is our knight in shining armour in EMS is incredibly naive. It is the government who intentionally keeps standards low. It is the government that refuses to recognise EMS as an essential service. Seriously, folks... who in the hell could possibly believe that government is the answer to any problem in EMS?

Second most awesome website ever: http://www.roadfood.com/ They have Five Guys listed and reviewed. Five Guys reminds me of Steak & Shake, which I am surprised isn't listed there too. I know they are everywhere. Seen them in Indiana, Tennessee, and Texas. I first found that website while looking up to see if any of the old "Lum's" restaurants were still around. They were a great hot dog place in the late 60's and early 70's that steamed their dogs in beer. There was a big discussion of them at the forum at that site. In that discussion, somebody divulged the secret recipe for the Lum's "Ollieburger" hamburgers that were the best ever! 3 Tbsp Lemon Juice 1 1/2 tsp Seasoned Salt 1 Tbsp Worcestershire Sauce 1 Tbsp Soy Sauce 1 Tbsp A-1 Steak Sauce 1 Tbsp Corn Oil 1/2 Cup Beef Broth 1 tsp Heinz 57 Sauce 1/4 tsp Garlic Salt 1 tsp Vinegar 1. Mix the above ingredients. 2. Take 1 1/2 to 2 lbs. of ground round and shape meat into round patties, 3/4" thick and 3 1/2"round. 3. Place in a covered container and pour the marinade mixture over them. Cover tightly and refrigerate 12 hours or overnight. Turn the patties frequently. 4. Remove from marinade and sear over high heat to seal in the juices, then turn down heat and cook to your desired doneness. Mmmm... now I'm hungry!

I did both for many years. Unlike firefighting, law enforcement is actually a very complimentary field to EMS. Firefighting is a labour job. Law enforcement is a thinking man's profession. EMS is also a thinking man's profession. Both are all about gathering facts and clues, intelligently analysing those facts and clues, and then processing that information in order to reach an educated conclusion of how to deal with the situation. Medicine is detective work, no matter how you look at it. That is one reason why cops tend to make great medics, so long as they aren't too caught up in being the next Buford Pusser. Of course, you can be a combined cop/medic in some places, but those are pretty rare and spread out. And the ones that do it usually only do first response type stuff, not full care and transport, which is very limiting. But you can work two jobs too, which I believe to be the better scenario. That way you can focus professionally on one specific job at a time, which is the better scenario. As 'Zilla said, "second job" is law enforcement's middle name, so that's not unreasonable at all. While I would not seriously discourage you from trying both, I would say that, if you do not intend to devote 100% effort to both, then forget it. If one of them is just going to be a hobby for you, then don't do it. Be a professional, not a tourist. Your patients and citizens deserve and expect that. And so do your partners. That means, go to paramedic school the right way, not the fast way. Then don't think you are done there. You will need to keep up continuous education, which means you not only have a second job, but also have to remain a student the rest of your career. If you don't have the time or interest in either field to pursue college educations in them, then you don't beling in either. Good luck!

I guess you could make the argument that, by establishing an IV, you make it a little bit easier for the paramedic intercept unit to save your arse after you darn near kill your patient through stupidity.

Anna, I don't know how long you were in EMS before leaving, but it looks to me like you learned quite a bit, and retained it too. Good luck to you. :thumbright:

Sorry, but all point deductions are final. No refunds. 8)

That's pretty much the point I have maintained in all of these union discussions here. Unions are like politicians. Their one and only goal is self perpetuation. Anything they do for you is just a byproduct of what they are doing for themselves. And although individual employees may indeed reap benefits from the union, the profession as a whole never benefits. In fact, it continually suffers. I'm looking forward to hearing what Hugopreuss and GulDukat have to say about this.

Minus five for posting in the wrong forum. Drug administration is ALS. Period.

And it took them two centuries to become recognised as professionals too. This is one issue I'd like to see EMS take a shortcut on. And come on, Marty. You know enough about statistics to not fall for any spurious claims of a cause-effect relationship here. That's beyond absurd.

Not a chance. This was about 1981. I've made a few runs since then, lol. I know I stole a sheet from the hospital as a souvenir. Pretty sure I still have it at home in a box of hospital sheets somewhere, lol.

Okay, am I naive to think that this quote must have been tongue-in-cheek? That's how I took it. He can't be serious, can he? :?

Exactly. Labour Unions are for labourers. I am not a labourer. I am a medical professional. Therefore, I have no need for a labour union. For those who want to be nothing but a labourer, go be a firemonkey and enjoy your IAFF brotherhood. Leave the profession to the rest of us. We intend to move the profession forward, not backwards.

I haven't worked any movie set stuff myself, but I do know people who have. Basically, I see two common situations. First, the production company just hires a local ambulance company to do it all, and they utilise their regular people and equipment. Second, the production company just directly hires an individual to do the primary medical coverage, and hires an ambulance company to have a unit standby for major and/or transport cases. This is similar to the typical sports standby, where the trainers handle all the care and the medics just assist and/or transport. I used to know a doctor who did a lot of standby stuff for the movie industry in the Dallas area, and he provided all his own stuff. Met a couple of nurses who did the same. I have heard of medics doing it like that, but never met any. That situation isn't particularly shady (although fraught with liability). But to have a middle-man contract to provide the service, then sub it to you without providing you any resources definitely sounds shady. There may be some kind of normal system in place though, where this commonly happens and the bases are covered. I can't think of how, but it's possible.

I'm curious if your school is actually utilising the "PPV" term a lot with you there, or if it is just a term that you somehow came to use. The reason that people are joking with you here is because I can't say I've ever encountered the term being utilised like this in an EMT school. Usually, they just say "bag him" or "BVM." 120 hours is way too short of a time to get people all hung up on scientific terminology like PPV that they really don't get a lot of education on. And I fear the terminology may be something that is hurting your understanding. Just because you elicited a couple of chuckles here, don't think that we aren't trying to help you. But, as SC said, we just need a little more to work with. I know you think this is as simple as a numbers game (i.e. over 30bpm = PPV), but it isn't. That's what we'd like to help you understand.

Highland Park, an exclusive (i.e. filthy rich) suburb of Dallas, does the exact same thing. Several other Dallas-Fort Worth towns did the same thing at various times (including Dallas-Fort Worth Airport, who started the concept), but all but Highland Park has ditched the idea now. A couple of others retain the "Public Safety" designation, but have separated the job functions and now share only a common administrator. Highland Park DPS has a nice website at http://www.hpdps.org/ , and a good overview of the DPS concept at http://www.hpdps.org/NewHPDPS/AboutUs/PSOSystem.htm . I went to medic school with some of their guys, and there were two basic types. Either they were cops who had an interest in EMS, or they were firemen who had little or no interest in it, but had even less choice. EMS wise, they send their people to the 90-day wonder firemonkey paramedic school in Dallas. They do have some medics who hired on after already being medics that have a better education, but they are the exception. They actually have one volunteer with that department, lol. An uber rich guy with a masters degree and his own successful business, who's lived there all his life. Paid his own way through an excellent medic school and fire certs too. I recerted with his medic class twenty-something years ago, and he's still there today. Probably the best medic they have, and definitely not a wanker. But they don't officially have a volunteer programme. Hard to find volunteers in that kind of community. Interestingly, the other area departments that combined EMS and Fire with Police services all did it with pre-existing medics, so there was never a need to send people to a quickie medic school to get staffing levels up. They all had medics with good educations and a lot of previous experience. All those departments ended up splitting back up eventually. One of them was the City Of Watauga, http://www.ci.watauga.tx.us/police/index.htm If you read the bio's of the police and fire chiefs, you can see the DPS roots. It shows the Police Chief started out with the city as a volunteer fireman, and it shows the Fire Chief holds a Master Peace Officer's Licence, lol. Back in the 1960s, it wasn't unusual to see a big city PD attempt to do EMS as there was no "normal" thing back then, except for funeral homes. Dallas and Fort Worth police departments both tried it briefly, but both went to private ambulance contracts shortly therafter. Of course, this was before ALS paramedic days, so I apologise for the sidetrack.

Okay, folks, this entire fourth page has nothing to do with conflict between medics. In fact, it has nothing to do with conflict on ambulances at all. Focus, please, or go start your own "conflict between medics and ER nurses" thread.

Sounds more like something you do while watching pr0n, than a medical procedure. Although, according to AK, that is a medical procedure. :jerk:

Hmmm... interesting theory. Where did you hear this, and upon what do you base your observations? I'm not arguing with you at all. I'm interested in hearing more. I work almost exclusively with Navy Corpsmen out here, and I am seeing a lot of under motivated guys, especially among the active duty ranks. Oddly enough, the reserve and guard medics seem to usually be better motivated and more professional. But my point is that this is not entirely a Whiskey issue. I suppose this would ultimately fall back on how the recruiters are informing their recruits. Are the expectations they are giving out now less realistic than before the Whiskey programme was implemented? For a historic perspective, I can remember talking to my Army recruiter in the early 1970s about being a medic. They would give you the 91A/B presentation very quickly, and then skip to focus on the remote possibility of someday attaining LVN equivalency as a 91C to suck you in. I'm curious as to how Whiskey recruitment is being approached these days. Plus 5 for actually adding something new and worthwhile to an old topic!

Definitely. This sounds like somebody who never learned to read XII leads trying to make himself feel better about this lack of knowledge. Nobody with a true understanding of XII leads and cardiac care would ever attempt to argue this point.