Dustdevil

That is definitely not a secret. In fact, it is such common knowledge that the public uses it against us come budget time. It is the number one reason why we are not yet -- and possibly never will be -- a true profession. Only because of the badges, sirens, and Dairy Queen discounts. If it weren't for that, it would be neither a job nor a calling. It would be a profession, just like every other medical service provider on earth.

Several good points here. Foremost is that this is indeed more than a simple wannabe hero thing here. This is a thief. You wanna impress your loser friends with bullshit war stories, that's one thing. But if you want to make a dishonest profit off of that -- a profit from MY tax dollars -- then that's even worse than being a simple liar. Forging federal documents to pull it all off shows a lot of intent. There is no "misunderstanding" here. It doesn't matter if the local DA drops charges of fraud and official misconduct. The federal prosecutor is going to have a field day with his arse. And it does sound like the FD is either stupid, or at least playing stupid. A shake-up is needed there too. This is some serious mismanagement. It makes them really look bad. I dunno if it gives firefighters in general a black-eye, but it certainly doesn't improve their image. There are losers in every profession though. The Special Ops community does not take kindly to these guys. There are many current and retired NSW and SF guys out there who make it their life's obsession to expose fake operators and push for both their humiliation and their prosecution. See this site for a basic primer on the topic. Google "fake seals" and you'll see how common this problem is, as well as how much effort is put into finding and eliminating the frauds. That said, there are definitely private contractors out here who are working special ops, side by side with military operators. I see them everyday, and they are to be seriously respected. Aside from making better money, they are taking every bit the risk and working every bit as hard as their military partners. But they also earned those credentials in prior military service. They're not just Joe Wannabe who took a weekend long "tactical medic" course in Houston and labelled themselves a "Special Operator." And they also don't go around telling people they are something they are not. These guys are perfectly comfortable and confident with who they are and don't need to go blowharding to anybody to pump themselves up. That right there is the difference. Most real operators you will meet, you will never know their true story, because they don't advertise it. It's hard to even pull it out of them. Nine times out of ten, if somebody starts telling you of their special ops heroics without a lot of prodding, it's bullshit. Or else they're drunk.

Excellent analogy! =D> One of these days, I will publish a book of EMS wisdom. That's two paragraphs that will definitely be in there!

Congrats. But did you mean "not to register," or "now to register?" :?

Excellent. I am glad that you have the full picture. The important point is that, just because a patient needs ALS does not mean that he needs to wait around for it. In most cases in America, he can be at the hospital just as fast, or faster than he can have ALS intercept. It seems all to common that EMT-Bs claim to know exactly when and when not to call for ALS, yet they prove here everyday that they do not. Then, after being proven completely incompetent, they continue to maintain that they are experts at knowing when to call for ALS. Just once I'd like to see an EMT-B admit that they are inadequately educated and experienced to be able to properly assess a patient and his need for ALS care. But honestly, I don't think I will ever see it in my lifetime. Proof positive of the danger of EMT-Bs working on emergency ambulances, and the need to eliminate that practice altogether.

We do. Please post all of your intercept reports here for review.

You would think so, wouldn't you? It only stands to reason that the National Association of Emergency Medical Technicians would be at the forefront of promoting the profession, as well as the various state associations and societies. But the truth is, I have yet to find a one that gets it. They all try so hard to be all-inclusive of the firemonkeys and volunteers that their purpose gets totally lost. There is not always strength in numbers. Sometimes the numbers only serve to dilute your message. That is what has happened with the NAEMT. And unless they ever decide to devote themselves to the advancement of the profession -- instead of just being a good ol' boys club -- they will never achieve anything of value for us. It simply will not ever happen. NAEMT is actually a very good representation of the state of EMS itself. Totally disjointed and un-unified with no focus, no vision, and no chance of ever growing into something valuable without completely re-inventing itself.

Geeze... Despite how clearly it was written, it took only one post for Tristan's question to get totally lost. This is not a theoretical question of the concept of potential first responders, folks. Tristan asked what you see in your area if you work on an ambulance.

Ah, that's good to know! A totally understandable confusion for a new student, but an unforgivable sin for an instructor. Good luck!

Common? Probably so. But standard? Definitely not. Hell, out here the EMT-Bs put in chest tubes and tracheotomies before I get the patient, and I don't go pulling those out. Discontinuing any intervention without first assessing the need for its continuation, as well as its effectiveness, is just bad medicine. Those same guys would probably DC a tourniquet just because it was there. Sounds like somebody is due an immediate attitude adjustment and some serious education. Or unemployment. Either way, I'm okay with that.

Whether a patient has a Combitube down or not, a medic's first step is the same. You assess the patency of the airway and the effectiveness of ventilations. If those are good, you're good. If they're not, then it's coming out. But it's not coming out just because I am pissed off because I got screwed out of an intubation, or because I have a chip on my shoulder about first aiders practising way over their heads. It's coming out because the patient's life depends on it. The best interests of my patient are my only concern at this point. Now, of course, the patency of a Combitube do not preclude me from still intubating the trachea, and I will most likely do that also. The Combitube is not (usually) a definitive airway, and since it's now my arse on the line for the patient's proper care, it is incumbent upon me to provide a definitive airway, regardless of what the EMTs did. So the question is, are you painting an accurate picture? Are they yanking all these tubes because they're arseholes who don't like EMTs? Or are they replacing a rescue airway device with a definitive airway because it is best for the patient? There is a difference.

I can't disagree with that. I'd rather be unhappy someplace new, where there is at least a little variety and excitement, then to be unhappy in the same place I've been unhappy forever. Nothing ventured, nothing gained. But dude, I sure wouldn't recommend just packing up the Pinto and running out there without a concrete plan and job offer. That's crazy. And really, if you're talking about breaking even, that's not much of a plan. At least try to do something that is an actual move UP. I mean, after all, if it is happiness you are seeking, is a lateral move really the answer? Is SF the only option left in the U.S.? Even if you are gay, I can think of a lot better options than SF.

EMT-B holds our profession down, no matter how quickly or slowly the course is run. Three weeks or three months, it doesn't matter. It's still a joke.

Pulses in veins is pretty bad too. :shock: You'd probably have better luck finding the pulses in arteries, friend. :wink: If an instructor actually told you that deep veins affected your ability to find a pulse, I would demand my money back and leave that school immediately before they totally screw you up. :?

Well, I am certainly the last guy here with the right to criticise anybody for rambling. Except maybe for Wendy. And in this business, I seriously encourage people to become introspective and examine their motivations and goals in order to put their careers into perspective and become comfortable with that. Everybody should be doing that, if not on a daily basis. Although, if everybody posted that here, I'd probably leave the forum, lol. But I've got to respect anybody with the guts to lay it all out there for public consumption like this. We just saw the risk you take by doing so. I have to admit that I am taking some things of value away from this topic. I wholeheartedly agree that Old Glory deserves at least a few minutes of my care and attention it takes to personally attach her to my uniform, even if it is only to stick the self-adhesive Velcro on the back myself. And I never forget the value and commitment of those who still find other ways to serve when my option isn't necessarily in the cards for them.

Yeah, ideally, the rural areas are someplace you move to after you have established a career with solid education and experience in an urban environment for a few years. It just takes a lot longer to get that done in a rural community. And, of course, there tends to be fewer experienced people to help you develop in a rural system too. You're more likely to be cut loose on your own too early there. Not to mention that most of your educational opportunities will be in the big city where the colleges and large medical centres are. The city is not overwhelming. More people = more ambulances, so while you will probably be busier, you should not be overwhelmed unless the place you are working just plain sucks, in which case you should leave. But busier means more experience in a shorter time, which is a definite plus. After a couple of years of that, then you can change gears and move to a slower pace, where your whole focus will change from rapid assessment and transport to long-term care of people in areas where the nearest hospital is at least half an hour away. Although your pace is slower, it is still an exciting challenge because the extended transport times allow you a much better assessment, as well as more time to use your skills on each patient. Even after a couple of years of city experience, you will still learn many new things working rural. Of course, a lot of people -- if not the majority -- only work one or the other for their entire career, and do it well. But ideally, if you have the choice, you ultimately become a better balanced medic by having both experiences. On the other hand, if you can stay at your first job for 20 years and retire without ever going anywhere else for your entire career, there is something to be said for that too, lol. I should mention that all of this is speaking strictly of 911 emergency EMS only. Anything else is just ambulance driving, and it doesn’t really matter where you work. Anyhow, I can't speak specifically about your area, as I know nothing about it. But that is the conventional wisdom of urban vs. rural. Good luck!

Contradiction of terms. Invasive airway procedures are ALS procedures. If you perform an ALS procedure, you are providing ALS. Any provider who inserts a Combitube is, therefore, an ALS provider. Perhaps you meant, "At what point will a Paramedic pull one that was established by an EMT-B"?

I'm actually considering getting some t-shirts printed up that say... Chuck Norris Kicked My Ass! Camp Habbaniyah, Iraq Anyhow, it's bedtime here. I'll post the story tomorrow when I get all the pics up.

Nick, I'll pay you twenty bucks to post here a lot more often. :thumbright:

Wait... you say all that as if you think I was joking. :?

If it delays the patient's arrival at the hospital, yes, you should be reprimanded. Once. Then fired the next time. Time is muscle. But I would say the same thing goes for your dispatchers. If they are routinely mis-triaging calls and sending BLS units on cardiac runs, they too should be fired.

Was this "party" attended by anybody besides you and her?

Exactly! Frankly, I am repulsed by the thought of so many people that would actually continue to wear a nasty arse shirt just because nobody else knows it's dirty. I know it's dirty, and that's enough for me to change it. If we're ever going to progress from a blue collar job to a white collar profession, we're going to have to take that first step of ditching the blue collars. It's a no-brainer.

Excellent points. VS is, of course, correct. This is a no brainer, and a question I am surprised anybody has to ask. But Anthony is also correct, in that it really doesn't matter how long your EMT course was dragged out, you're fooling yourself if you think you're going to be saving a bunch of lives. CPR is about the only thing you learn that will contribute to that process, and I can teach you that in a day. Basically, EMT-B is so useless that I really don't care how you learn it or how long it takes, so long as you retain it and immediately continue your education to professional levels.