Dustdevil

I can assure you that I do not shortchange my patients when it comes to analgesia. I am quite liberal about it, paperwork be damned. But yes, I do think that inadequate pain control is a serious problem, not just in EMS, but in medicine in general. I spent almost a week in the hospital out here several months back and experienced the problem first hand. Some of the worst pain in my life, and yet they couldn't seem to get past the old "2 milligrams at a time" box of thinking because that's what their books said back in nursing school, and they've always done it that way. Never mind that I was obviously not getting ANY relief, and that I wasn't even getting drowsy, much less getting dangerously sedated. So WTF? I've seen it a lot in EMS and in hospital and clinical practice, and it always pisses me off. Times are changing, but all too slowly.

Worst. Show. Ever. Although, I never saw "Saved," so I could be wrong.

It is the timeless, definitive biography of EMS. If you haven't seen it yet, you aren't in EMS yet. And do we really need to remind somebody from the supposedly computer literate generation that GOOGLE IS YOUR FRIEND? As is the EMT City search function, which would reveal several threads covering this topic.

Preceptorship is sort of like a field internship. And in some places, the terms are interchangeable. Usually, the distinction is in the timing. Most times it is done after all of the classroom requirements have been fulfilled. Sometimes not. But it is always before graduation, wheras a proper internship would generally be after graduation. A preceptor is usually the senior medic that is assigned to guide and evaluate you through your preceptorship/internship period. However, sometimes there is no one single person assigned this task, and you rotate among several crews.

Interesting question. I tend to agree with your assessment, but with some situational stipulations. Do you have the resources to commit to these types of transports without compromising EMS coverage? Do you have a way to ensure that you actually get paid for these? Remember, to get government or insurance reimbursement for them, there is a good chance you are going to have to commit fraud. Even then, you wait six months to receive only a fraction of what you billed. Generally speaking, this is not a smart business move. If you're going to run a taxi service, horizontal or otherwise, you need to run it like a taxi service, not a charity. That means fee for service, not free for service. In Allah we trust. All others pay cash. Of course, this leads to the bigger discussion of whether your personnel are capable of competently determining who is and is not a legitimate medical patient without letting people fall through the cracks, die, and/or sue your arse off. Therein lies the dilemma.

Theft is less than half of the concern. The major portion of the concern is for the safety of the crew and patients. That is why I say ALL doors are locked at ALL times. Not just when you park it and leave it. Nobody is going to open a door on my unit while I am in it OR if I am out of it. You need an official written policy to make you do the right thing? Unless it is a violation of written policy to lock your vehicle, why would you not just do it without having to be led by the hand?

Plus 5 for using "ethnocentric" in a post. But you lose 5 for all the "..." and another 5 for not bothering to use capitalisation, so you're still in the red. :wink:

Yeah, not a big fan of Thomas packs at all. Overrated. Overpriced. Underfunctional. Ugly.

This is quite possibly the most derailed topic in the history of EMT City.

My protocol would be to fire both you and your partner for violating the written policy that states ALL doors will be locked at ALL times. :wink:

Unfortunately, these quick fixes are like bailing wire on the muffler. Sure, it's not dragging the pavement and throwing sparks into the air anymore, and consequently, fewer people will notice the problem. But it is still creating one hell of an annoying racket. And it is still spewing nauseating exhaust fumes and deadly carbon monoxide into the passenger compartment of your car. We can't leave it like that forever, no matter how much the manufacturers of bailing wire would like us to. People are dying.

Teddies are ALWAYS appropriate at my parties! :twisted:

Same thing I am always doing with an AK! Trying to figure out how I am going to get it back to the US! 8)

I am recalling the previous discussion now. It was said that most of their units are BLS only, and that they will take ALS runs and not back off of them for medics from other agencies, even if the medics are on scene. It is also said that they will respond very long distances when it is quite clear that other agencies have closer coverage in that area. Like most volunteer agencies -- if the rumours are true -- it seems to be more about the agency itself than it is about the patient.

LOL! Some things never change. Our trucks may have sucked in the 70's, but at least there was no such thing as an old ambulance then!

You guys are too young to remember the really good traditions we had back in the funeral home days! Let's just say, you better hope you had an extra pair of clean pants with you on your first night sleeping in the funeral home! :twisted:

LOL! It's a good thing you cleared that up straight off, or some might derail this topic with questions of your mental stability! Texas is sunny and warm. Well, sunny and HOT is more like it. And reciprocity isn't a big issue. They *might* ask you to take a 24 hour EMT refresher course, so that you can get a quick exposure to the local ways, then let you challenge the NREMT exam. I know one EMT City member who is an ACP from Ontario did that without any problems. You might check with Cypress Creek EMS in Houston. They have experience helping Canucks make the transition and are good people to deal with. They run their own in-house education, so it is very, very convenient. You won't be stuck running all over the state chasing classes down. You'll stay very warm and very busy in Houston. Good luck!

LOL! Well, I didn't really mean them as "levels" in the certification sense. More of an educational level to strive for. And eventually, an MS requirement for teaching. But no... for now I can still support full practice privileges with only two years of FOCUSED AND QUALITY education. Nothing less belongs on an emergency ambulance.

Seems like there was a thread about Hatzalah here quite awhile back, although it does not come up in search anymore. I recall it was less than flattering. Some charges of poaching and unprofessional/unorthodox medical practices. I dunno. I'm only half Jew, so I was only half interested. That was the first I ever heard of the guys though.

Yo, Alert! Quality post. Welcome back, Bro!

Interesting. I just can't imagine where any of us might have gotten that impression! Interesting. This place has been chewing up and spitting out wankers and wannabes for the entire two years I have been here. I guess it must have gotten that way in the two months between when you joined and when I joined. Regardless, progress is a good thing. It's all about quality now, and apparently it is working, as our numbers continue to grow. Interesting. It VERY much is in writing in the Texas Motor Vehicle Code that you either use both or neither. Your small town is making up their own laws? And do you think they are going to admit their "pretty much" requirement in your defence in court? Think again! Interesting. But, according to your very own personal website, you are "...currently testing for fire departments in hope of getting a job, and making the big bucks! So it is perfectly reasonable that some here might have legitimate questions about what you "do for a living" that is so imperitive to mankind that you need emergency equipment for your 1972 Ford Pinto. If this information is incorrect, then perhaps you should update your website rather than getting cheesed off at people who take you at your word.

Tis more blessed to give than to receive. When you're done "taking" from the profession, how about growing up and giving a little back?

If that is the only downfall you can think of, then you didn't think about it very seriously or very long. :? There's not enough bandwidth here for me to list everything I find wrong with it. But I disagree with my colleagues who call for only two levels of providers. There should be three. AS Paramedic. BS Paramedic. MS Paramedic.

Plus 10 for the most informative post of the week! =D> In the military, we occasionally see that exceptional enlisted man who stands out from his peers and is obviously destined for greatness. These are the guys who are promoted ahead of the others, and sometimes even moved into the officer ranks because of their outstanding potential. I think you are that kind of person. I doubt I have to tell you this, but please... do NOT sit back and relax now. You're not a worker bee. You're a leader! Go STRAIGHT to paramedic school! Unless, of course, you lack the basic sciences (A&P, Microbiology, algebra and psych), then get right on that. Your maturity, intelligence, and communication skills are sorely needed in EMS to help lead our image for the twenty-first century. I wish you had a blog. I would read it and recommend it to other students.

Don't sabotage yourself, Bro. While there are certainly a fair share of dickwads in EMS everywhere you go, there are also a lot of good guys out there. And, just like those that come to The City, there are quite a few who are either old-timers in the biz, or old-timers on their second career. Those guys won't have a problem with you at all, unless they are just dicks to everybody in general. And of the young'uns, there are still quite a few who were raised right and have respect for their elders, regardless of their position, and treat them with dignity and respect. I also find that quite a few young medics really appreciate having older students join the ranks. It's refreshing to precept somebody who is mature and serious minded, instead of the usual annoying wanker who won't shut up about all the pointless crap long enough to discuss serious medical topics. And those medics are not threatened by your maturity. They embrace it, and it is a satisfying ego boost to them to be able to teach somebody who is their senior. As for the zero-to-hero thing, I really haven't ever seen that present a problem in the student-preceptor relationship, in my experience. Never. Generally, I see two kinds of student-preceptor relationships; the ones where the student's attitude and presentation sets the tone, and the ones where the preceptor is just a dick to everybody. The ones where they are just a dick to selective people for arbitrary reasons like age, weight, sex (or lack of same), etc... are anomalies. Prepare for the worst, but expect the best! Positive mental attitude is the first rule of survival.