Dustdevil

Levaquin.

That is the least of my concerns. I am more worried that the anxiety of lights + sirens can possibly stress my driver out, increasing adrenaline rush and decreasing his/her attentiveness and causing me and my patient an unsafe ride for maybe 60 seconds of saved time. You are correct that it is not debatable. However, it appears that you are trying to debate it anyhow, which is a sign of your inexperience. I have faith you'll grow out of that, though, so I'm not overly concerned. But multiple studies show that it simply is not worth it to be bombing through intersections and blowing people off the road to save a minute or two of time enroute to the hospital with a non-surgical patient, no matter how critical they are. They fact that your patient coded four or forty times is irrelevant. Arriving twenty minutes earlier would not have stopped that. Except under the most unusual traffic circumstances, this patient would not have gotten lights and siren out of me.

LOL! Good luck with that. This has been to court many times, and has always been upheld. Just like dress codes and codes of ethical conduct, personal habits that impact the image of the company may be regulated within the workplace. The popular theory of homosexuality remains solidly in favour of genetics, making it off-limits to these kinds of things, just like obesity or other disabilities. But anything that is a personal choice is fair game, and he who puts his money and life into the business gets to decide how he wants his business represented. Don't think for a moment that the courts would side with smokers on this issue. The courts even threw out the case of the man who wanted to be a Hooters girl, and that was clear cut discrimination.

You work for the government? :?

A medic out here did that last year. :roll: Box clearly says in big red letters... FOR USE IN EARS ONLY!, and has a big picture of an ear on the front. This is what you get when you take ambulance jockeys and put them in a clinical setting without all that book learnin.

Not really. You said yourself that the smokers will continue to smoke despite the ban. They can't be trusted to obey the policy. Therefore, this is how they plan to keep the cigarette butts from showing up all over the place. Nobody smokes. Nobody leaves butts.

Okay, two questions... 1. If he is so terrified of Iran that he leaves seeking asylum, wtf does he go back for? 2. And really, doesn't everybody say they only had "two beers?" I hope he doesn't have to pass an IQ test for his citizenship.

Yeah, about half the people who announce their new job here are taking ER tech jobs, not EMS jobs, so it is a little confusing when you just say "hospital." It's a good sign that they only work 12 hour shifts. But it sounds totally unreal that they would ask you to work 36 in a row. Unless I am misunderstanding that, seriously... I question the intelligence of the people running that operation enough to ask them straight up, "Do you think it is really smart to work somebody 36 hours straight without a break?" and find out what they are thinking. Unless they tell you that you misunderstood them and that they did not mean 36 hours straight, I'd be inclined to say, "Thanks, but no thanks."

You're definitely on the right track with renal failure. The remaining question is 'why.' This appears to be an acute condition. But with her history of multiple chronic illness and polypharmacological lifestyle, it's not surprising. I'm going to put porphyria towards the top of my list. Wherever she is going needs to have a quality lab and dialysis availab.e

Not to mention Niacin. Y'all get Red Bull in 600ml bottles? :shock:

Good call. The same thought has crossed my mind. Yes, sometimes truth is stranger than fiction. But although the scenario itself is quite believable, this guy is just so absurd that I'm thinking somebody is just having fun with us.

No. Smoking is a voluntary habit, just like masturbation or surfing for pr0n on the Internet. It limits your productivity on company time and is fair game for regulation. Obesity is a physical condition protected by the ADA. Not even in the same ballpark.

Yep. But if it makes you feel any better, I've watched physicians make the same mistake. Recently, even.

Well... there goes the entire Respiratory Therapy department! Good decision. You'd sound silly if you did. Smoking is public behaviour that has multiple relevancies to the workplace, not the least of which being productivity. I wouldn't hire tobacco users either. Why would I when there is no shortage of non-users to fill the ranks? Productivity soars. Image improves. Absenteeism drops. Insurance rates drop. I don't see a single negative to this equation.

Whacking into the sunset. I've known a lot of guys in Oregon EMS. They're a serious bunch. They'll lynch this guy within a year.

LMAO! Dude didn't even have a valid DL? Now THAT's classic!

Yep. Badge FD ballcap Kojak light Siren FD sticker on the back window Scanners Plano 747 trauma kit Vollied with a VFD off duty At least I was relatively discreet with it all though. I didn't go around with the badge around my neck or on my belt. No lightbars, magnetic signs, stethoscopes hanging from the mirror or my neck, giant tool pouches on my hip (on or off duty), or whacker pates on my car. I was a serious whacker. Maybe even a wanker. But I had my limits.

They both worked for me. But they do both take a long time to load, especially the first one. It took several minutes. Right place at the right time. Good work on their part.

And I'm not into being driven at 90 with L&S. You can be my partner anytime. :wink:

Yes. In the future, please give us a subject line that actually tells us what the topic is about. We dislike teasers. I'm a little leary of this 36 hours straight thing. But without knowing exactly what a shift consists of, activity wise, I'll withold judgement. Anyhow, you're not being really clear about this, and people are already tired of playing the guessing game. Is this hospital based ambulance that you are talking about, or what?

Vent and CH have covered this so thoroughly that I really have nothing significant to add. I would just add to the specific point about nursing being opposed to EMS education, that I have never seen or heard of this. Not in any form or shape. In fact, I have never seen EMS education officially addressed by the ANA or ENA, except to say that it is insufficient preparation for working in the hospital, which is indisputable. They have never opposed the elevation of EMS. It is those who try to take EMS practitioners off the streets and move them into other professional territories that are hurting the progression of EMS. Everytime one of us tries to say that we should be allowed into the hospitals, what you are really saying to the public is that EMS is not worth staying in. That makes you guilty of hurting the profession. An EMT or paramedic mouthing off about how qualfied s/he is to work in a nursing capacity in the hospital is really about as absurd as the Jiffy Lube tech talking about how qualified he is to be a jet mechanic. It's just so blatantly ignorant that it's embarrassing, and proof positive that you are NOT qualified. Respiratory therapists, lab technicians, x-ray techs, physical therapists.... they all walk in nursing territory. Ever wonder why the ANA doesn't fight them? They did at one time! But those professions established PROFESSIONAL EDUCATIONAL STANDARDS that qualified them to take over that territory. Once that is done, nursing is not opposed to having a burden relieved. But anytime you are talking about taking over a duty with substandard educational preparation, you can bet that nursing is going to oppose it. That is their duty as patient advocates, and they do it well. If you are doing anything less, YOU are not a patient advocate. And if you are not a patient advocate, then you are just in it for yourself, so good riddance.

Yeah, that EKG is what I was looking for. It confirms what I was thinking, pill bottles or no pill bottles. She's going to be very lucky if she makes it. If I am very rural or remote, I might do a little lavage during transport. Otherwise, it's just fluids, bicarb, and a little mag to try and close that QRS gap. Failing that, dopamine on a long trip. The gag reflex won't be there for long, so she buys a tube too.

"My life my choice!" makes a nice bumper sticker slogan, but welcome to the real world. I don't have to take you where you want to go. There is no law anywhere in the U.S. that says I do. I have a duty to provide you with aid and transportation, and you have a right to refuse it, but if the facility you like is deemed inappropriate by my medical authority, then you're SOL. Now you can either go where I plan to take you, or you can lay there and rot in the dirt where you lay. You may have a legitimate issue with whoever supposedly "butchered" you, but I will be laughing at the $300k you waste trying to get a civil judgment for "kidnapping," because you simply have no legal precedent on your side at all. There was no winning with you, dude. You bitch if they don't transport you where you want to go. You bitch if they don't transport you at all. You're just a chronic complainer who caught a bad break and now decides to share his misery with the rest of the world. Good luck with that. The hours may be good, but you aren't going to see the payoff you think you are. Then you'll just be more miserable. Head injuries and mental problems are not the same thing. And your failure to understand that is further evidence that you simply don't know what you are talking about on any level. No, it's not a fact. Again, more clear cut evidence that you don't have a clue what you are talking about. Ninety-nine percent of EMTs will never even finish a semester of college, much less graduate. EMT "school" (using the term very loosely) is a 120 hour first aid course, and nothing more. They're making the same money as the guy who served you your last Big Mac. What exactly did you expect from somebody with that little training, orthopaedic surgery? It is painfully obvious that you wouldn't know the "truth" if it bit you on the arse. You're making a lot of silly assumptions about medicine and the law that only somebody who watches too much television would make. It is also obvious that you don't even have a lawyer or a case, because any decent lawyer would have told you to STFU a long time ago. Do yourself a favour. Do a little research into the "truth" and get back to us. You'll be embarrassed at what an idiot you are making of yourself.

I am saying that might theoretically be the case. We have long known that some forms of shock begin as a compensatory mechanism. This is why we don't use MAST and pressors in hypovolemic shock. The same theory would seem to apply here, where a raised pressure may have resulted in fatal problems. There are a lot of questions that would have to be answered to determine if this were true, but it is something to think about. This is why it is so important to have the education to actually understand pathophysiology, and not just memorise protocols to be blindly followed. Every patient is different, and few of them are following our protocols.

Whoa... slow down there, Bird! You are definitely overloading yourself with a lot of decisions that you don't need to be concerning yourself with yet. Where you're going to work first? Where you're going to work second? Where you're going to move to? First things first. Let's get your education out of the way before you start looking for jobs. 1. Education 2. Location 3. Education 4. Job 5. Education 6. Career changes Ummm... no. College courses come BEFORE working on an ambulance, not during or after. This is brain surgery you are talking about performing, not carpet cleaning. Would you want somebody with no education learning medicine OJT while your mother is the patient? Of course not. Establish a solid educational foundation before you start taking human lives into your hands for fun and profit. Of course, any desire to live in NYC is a symptom of a qualified insanity. A desire to move there just to work FDNY is a symptom of watching too much Turd Watch. But hey... whatever makes you happy. NYC, Atlanta, Detroit, whatever, so long as you give one hundred percent to being the very best you can be. Every system needs good people. It is not logical to work as an EMT for awhile before beginning your paramedic education, unless you are truly unsure that you really want to do this for a career. In that case, a little exposure ahead of time may be helpful to your decision process. But don't let anybody tell you that EMT experiences "for awhile" is helpful to your being a good paramedic in the future. It's nonsense. You shouldn't start any career not knowing wtf you are doing, and then try and go back and learn after the fact. You darn sure shouldn't do that with human lives. As for going to medic school while working as an EMT, it is going to depend on the school you are attending, as well as the organisation you are working for. It will also, of course, depend upon how good of a student you are. Look back at your high school experience for a clue. Did you have to bust your arse studying to make passing grades, or did the educational process come pretty naturally to you? Were you the kind of student who put in more effort than was required to simply pass so that you could excel, or did you just do what was necessary to get by? What kind of shifts does your (future) employer work you? Do they work you on 24 hour shifts? Then forget it. You'll play hell trying to attend Monday-Wednesday-Friday classes with Tuesday-Thursday labs and clinicals while working 24 hours shifts. Does your (future) paramedic school have classes only every third day in order to cater to the firemonkeys? Then forget it if your employer has you working 12 hour shifts everyday. Every employer and every school runs things a little differently, so these questions are going to be very location specific. But these uncertainties are just another reason why you should get your educational foundation done BEFORE entering the field. Very few people who enter the field first every go back and get the job done right. Working too many hours. Working erratic hours. Working overtime because their pay sucks. It’s just very hard to make it work. Everybody -- and I mean EVERYBODY -- who enters EMS as a career faces a certain amount of disappointment and disillusionment. It's not as cool and exciting as a television show. In fact, it is so little like any television show you have seen that you will be surprised once you get in. Every run you make is not a critical trauma case that lets you use your education and training as well as your lights and sirens. In fact, nine out of ten runs you make are total bull$hit. And nine out of the ten patients you have that do require your education and training will not benefit from your efforts because they are too far gone to begin with. You start feeling useless pretty quickly, unless you're stupid enough to fool yourself into believing you are more important than you really are. And that illusion only lasts so long. The pay sucks. The hours suck. The career options suck. Half of your co-workers suck. Three quarters of your supervisors suck. The potential for advancement sucks. And the potential for ever retiring with a pension is non-existent. The truth is, there is very, very little about EMS that is positive. What keeps the professionals going is the promise of a better future, and the desire to be a part of the force for change. What keeps the others going is the fact that they are too stupid and lazy to get a real education and go do anything else. Unfortunately, they outnumber the professionals by about 3 to 1. Are you looking for a career, or just a temporary job while you decide what you want to do when you grow up? If you are looking for a professional career, then you need to immediately start thinking long term. You will not (for your sake) be single forever. But on the current average EMS salary in this country -- especially in cities with a horrendous cost of living like NYC or Atlanta -- you will never be ready to comfortably provide for a family. There are, of course, exceptions. But they are few and far between and very, very competitive. Again, a lot of us are working hard to change that in the future. And if the new generation of medics get on board with professionalism from the get-go, we can indeed change things. But I certainly wouldn't look for any significant improvement in the next 5 to 10 years. Only if you let it. EMS is not a calling, a hobby, or a lifestyle. It is a job just like any other job. You clock in, and you clock out. Then you're done. Except for always continuing your education, the rest of your time off is the same as anybody else's. Raise a family. Travel. Tend a garden. Play music. Play paintball. Whatever. Just don't take the job home with you and your life will remain yours. But if you insist on hurting yourself and the profession by being a volunteer whacker somewhere in your off time, then yes... it will consume you. No. Absolutely not. It is a profession. It should be treated as such. Again, it is not a hobby or something to do until you decide what you want to be when you grow up. In order to do the job justice, you need two years of full time education to even sit in the ambulance. That's too much commitment for a transition. And if it is too much commitment for you, then please move on. I'm not sure what you mean. If you are asking if it is worthwhile to work as an EMT for a couple of years just for fun, without any interest in an EMS career, just so you'll have some neat stories to tell, or the slim chance that you might actually need that experience someday, then the answer is no. In fact, the large number of people who pass through EMS with those sorts of intentions are one of the main reasons we fail to grow as a profession. Absolutely! I wish I had the benefit of hindsight to guide me through my professional development. I wish I had somebody who had spent thirty years navigating this professional minefield to advise me on the things to concentrate on and the things to avoid without mincing words. Unfortunately, EMS was about 2 years old when I started, so I had to learn all this crap the hard way. The VERY hard way. Plus 5 for asking serious questions before taking the plunge. When you get into EMT school, you will be surprised how many people in there haven't done the first bit of career research. They don't know if or where they might find an EMT job. They don't know how much it pays. They don't know what the professional future is. All they know is blood and sirens are cool. Then they come here asking these questions after about three months of not being able to find a job. Kudos to you, and good luck!