Dustdevil

I don't think such clarification is really needed in NJ. State law covers it very strictly. I think where you will need clarification from is from your actual employer. There are employers who are not at all fond of their paid employees doing the same job somewhere else for free. And with NJ being a big union state, they are probably even less fond of it. You cannot possibly understand how maddening and frustrating it is to work at a greatly reduced scope of practice until you have done it. Your desire to do it will decrease greatly once you've tried it for awhile. Hopefully sooner. And, of course, the reason you are going to have a tough time finding a paramedic job in NJ if you ever finish school is because there are so many people willing to give it away for free, so there aren't that many paid jobs to be had. Think hard about that. I'm sure it happens quite a bit. Whackers abound in the Northeast. But it's not a good plan.

Which makes it a little amazing that -- if they are going to let ANY techs do it -- they only allow the EMT to do it. Anybody could do that. Does not the triage nurse also do this? Why is everybody getting screened twice? Are they delayed from seeing the triage nurse just to see you first? If they pass your test, do they go back to the waiting room, or do they also see the nurse immediately? When you say you are "allowed" to do this, do you mean it is actually an assigned part of your job? Or do you mean it is just something that you do because nobody stops you? Show me an ER that uses EMT-Bs for triage, and I'll show you an ER that has too many EMT-Bs. Show me a stroke centre that uses EMT-Bs for this, and I'll show you a stroke centre that sucks.

Well, there is the guy with almost the exact same question in the topic three below yours. Stopped at 70 Minus five for not searching previous topics. But yeah, the cleaver topic title and posting in the correct forum gets you your points back. :wink:

If systolic time were decreasing, you would see a shortening of the QRS. Compare the EKG of a person before or after the tachycardic event to the one during the tachycardia and you will see the QRS does not change (unless there is pathology behind the event). It's the same QRS just being repeated more rapidly. Therefore, it is only the interval between systoles that changing. The interval between systoles is diastole.

Can you tell us more about this "ACLS competition?" At first I thought you were just talking about like a mega-code thing. But after reading the OP again, you're talking about multiple patients and a chaotic scene, so I'm thinking you mean more of an MCI exercise than an ACLS thing. And what exactly do you mean by... Do you mean they didn't do a head-tilt/chin lift, look listen and feel thing? On conscious or unconscious patients? You do know you don't have to do that on conscious and breathing patients, right? And you do understand that in actual practice, you don't verbalise all your steps like you do in class, right? Sorry, not saying you're stupid or anything, but I have seen many new students not understand these things in the beginning. Or, are you saying that these guys jumped straight to drug interventions on unconscious patients without ever beginning the CPR process?

There is a large perceptional difference between competition and actual practice. In actual practice, you can assess ABC's without announcing it. This is similar to scene safety and BSI. In EMT school, you have to stand there and verbalise it. In actual practice, you just do it and nobody even notices. In fact, a lot of what a good medic does is so smooth and natural that bystanders, partners, and even the patient commonly remark afterwards, "I didn't even notice you doing that." Perhaps that perception is what leads to the confusion over this issue. But, of course, maybe not. Some people do indeed work with their heads up their arses and make stupid mistakes. We see and hear about it everyday. But it has not been really common in my experience to see even rookies totally overlook the ABCs on a patient. To jump right to intubation without trying anything else first? Sure. I've seen that. But not to totally forsake ABCs altogether.

LMAO!!! :laughing3: Good point!!

It's amazing how often this kind of thing happens. People use up their last bit of energy and determination to make it to the proper place to die. It's a basic primal instinct inside of us. In the animal kingdom, animals typically know when it is time to wander away from the pack and find a place to curl up and die. I've seen dogs fatally run over on the highway, but they somehow use that last 5 seconds of life to crawl to the side of the road to curl up in the grass and die. The interesting thing is that there is one other time you see this instinctive behaviour, and that is when a mother goes to give birth. Ever notice your pregnant dog or cat disappears right before giving birth, only to be found under a bed or in the back corner of a closet? Luckily, this instinct, coupled with the intelligence we have developed through our evolution, leads to a lot of people getting to just the right place at just the right time. I'd be willing to bet that the patient in the above story had that textbook look of "impending doom" on his face too. That is one of the most ominous signs in medicine. Once you see it, you'll never forget it and always recognise it in the future.

I plead the Fifth. Let's just say it's a good thing there was no such thing as Gall's in the 70's. :oops:

LOL! I think it's a good thing. It shows transparency and encourages the public to hear them in action, which is a good PR tool. Although, I am a little disappointed that they don't give any useful demographics, like the size and population of their service area, the number of runs they make and average, and a breakdown of what kind of runs they make. Those are also things that show the public you're worth the money. Or not. Minus 5 for this statement though... Apparently they have no paramedics, or they would know better.

Yeah, ideally you would have had A&P instead of the phlebotomy and EKG classes. Neither of those are common downfalls for students. Most common downfalls are cardiology (not EKGs, but actual cardiology) and pharmacology. A strong A&P foundation makes comprehension of those two topics much easier. Plus 5 for considering any of this ahead of time. I think you'll do fine, but don't get through the course and think that, since you're a paramedic, you don't still need to go back and get those A&P and microbiology classes done. And, of course, any school that doesn't require those as PRErequisites probably sucks, so beware. Good luck!

Eager, hott n00bs is actually one legitimate reason for keeping EMTs around in EMS. I'm guessing this is a system where the medics are allowed to wear skirts? :shock: A lead transfer truck? Does the EPA know about this?

Not to be a party pooper, but this doesn't really sound like something award-worthy. It's the luck of the draw. You happen to catch the run. You happen to be in close proximity. You interpret a simple single-lead EKG and happen to follow the right protocol which happens to work because the patient happen to have the right combination of conditions going for him. Any other medic in the organisation could have and would have done the same thing given the same circumstances. Not exactly an "above and beyond" kind of deal. Awards mean a lot more to people if they have to actually earn them by doing more than just showing up to work everyday. If I am giving awards to my personnel, they are going to be for educational achievements, progressive ideas and actions, portraying a positive public image, and any actions that are truly above and beyond the norm. Heroics will be rewarded only if stupidity is not involved. But just doing what everybody else does or would have done doesn't really qualify for praise. If none of your people are really doing any of the above, then standing up and telling them that at an awards ceremony where no awards are given would certainly drive home the point. Of course, if this is a volly organisation, then you have to blow a certain amount of smoke up people's arses to make them feel appreciated and stick around, I guess. In that case, it might be appropriate to add in "saves" and attendance for recognition. After all, professionals get rewarded for just showing up by getting paid, so some kind of reward is also in line for volunteers showing up. But those would certainly be lower on the priority list below the other achievements though.

About this whole "intercept" thing... the concept itself is pretty foreign to me. I've thankfully never worked in a "tiered" system. Every system I ever worked in had all trucks staffed with a medic. Actually, usually two medics, or a medic and an RN. Intermediates have been a dying breed in most of Texas for almost 20 years. I part-timed at a rural county service for a few years that ran two trucks, and sometimes one of them would run with only an Intermediate on board instead of a medic. In that time, I never experienced being inappropriately called for a scene intercept. They may not have all needed ALS interventions, but they all certainly needed ALS assessment. And the Intermediate was good about not calling for an intercept when it would delay the patient's transport. Of course, I have no idea how many times he didn't call for a medic when he should have, but I don't think that was a significant problem. Is this inappropriate use of intercepts really a rampant problem in places?

Of course I can't speak specifically to whatever situations you are referencing, but this is definitely not an FDNY thing. It's typical EMS immaturity that has been around as long as me. You gotta figure that most of the FDNY guys probably worked for privates before they got lucky, so they carry a personal connection to whoever they used to work for. I've seen a lot of n00bs strike out at their former employer's units and personnel once they hit the big time, thinking they are now somehow better than the others. I'd be checking the hospital security cam tapes and filing charges on a couple of those arseholes. That'd put a stop to it real quick. Again, I can't speak for those guys or FDNY policy, but I've had more than a few patients who refused to be carried in, stating "I walked into this mother F'er, and I'm going to walk out!" Invariably, it's always some dude with a bloody head too. Go figure. It's not like you can stop them, so what are you gonna do? Yeah, they're probably just lazy idiots, but hey... everybody gets the benefit of the doubt.

Cool. Good job on understanding the importance of a solid foundation. Do you have the option of attending a full paramedic school instead of going the Intermediate route first? I know in some, mostly rural places, the Intermediate route is the only route available. But if you have the choice, seriously... skip the Intermediate thing. It's a sub-standard way to go, not to mention, a longer way to go. Because it really isn't a useful level at all, it is disappearing from many states altogether. And those who already have it find it harder and harder to find a completion class, and end up having to attend a full paramedic programme anyhow. It was a good thing at one time, 25 years ago, when EMS was still trying to establish an educational system and limited skills outreach programmes like that were still an advancement. But these days it is well recognised that a fragmented and disjointed educational plan in broken steps like that just doesn't prepare you well for advanced practice. Not to mention that we have also pretty well established that the limited skills you acquire with EMT-I just aren't that useful in an isolated context anyhow. Sounds to me like you are a serious and intelligent person who knows what he wants to do. That is the kind of person who needs to move straight for the big prize, and not get sidetracked by shortcuts and intermediate steps. You'll get to medic faster, and learn better. Good luck!

Hey, nobody is going to count food against you. Nothing wrong with that. I would subtract 10 points for the BDUs and the Skoal though.

You just love to start trouble, don't you? http://www.emtcity.com/phpBB2/viewtopic.php?t=4896 http://www.emtcity.com/phpBB2/viewtopic.php?t=6707 http://www.emtcity.com/phpBB2/viewtopic.php?t=4388 http://www.emtcity.com/phpBB2/viewtopic.php?t=792 ... among others.

I think his point was that, if those settings are changed, it will not be you -- the EMT -- who is responsible for changing them. It will be the RRT. The most you are going to have to do is to bag this patient while the RT troubleshoots a crapped out machine, or maybe help him set up to suction.

Which is another illustration of why the so-called "tiers" in EMS should be eliminated. :wink:

Nice website overall, for a simple HTML job. Not too whackered out. Minus 5 for promoting pics of a dumpster fire on their front page, lol. Plus 10 for having a memorial page to their Dalmatian mascot though.

Browse through the "student" forum (where most people ask this question) and you will find many similar questions with lots of good advice. Number 1 advice: If you are serious about EMS as a career, forget training and get some education instead. Skip Intermediate school and get into college. You will acquire more relevant and useful knowledge in a semester of Anatomy & Physiology than you will in any Intermediate class. Knock out A&P, Microbiology, Chemistry, Algebra, Psychology, and Sociology, then go straight to Paramedic school and be the best you can be. Without all that, no matter how well you do in Intermediate school, you'll still be half arse. Good luck!

Wow... you really don't understand the concept of education, do you? I don't recall any ALS providers here saying they wanted to educate anybody. In fact, I think it has been pretty unanimously stated that we want to work with people who are already educated so we don't have to educate them. I am assuming that you went to school in your younger years, so I would expect you to understand by now. When you want education, you go to school. Your teachers went to school. Their teachers before them went to school. What makes you think that you are so special that we suddenly need to break the cycle of education and start "educating" you on the job when there are schools established for that purpose? If you don't want real education, you're in the wrong field. And you're definitely barking up the wrong message board. NOT SPELL CHECKED. I paid attention in grammar school.

Funny how often we see these "expert" packagers and movers have patients walk from their demolished auto to go lie down on a backboard themselves. Funny how much dust you see on a lot of these experts' KEDs. Funny how often I arrive on the scene to find an expertly packaged patient who hasn't even had his vital signs taken. Actually, none of that is really funny. It's just sad.

EMT = Non-Alcoholic American Beer Paramedic = American Beer Degreed Paramedic = Beer RN = American Sparkling White Wine RN/Paramedic - Champagne