Dustdevil

Yes, it really varies. Depends on what they want their techs to do and how desperate they are for help. I've certainly seen quite a few places that were more than happy to hire a new grad. Probably most want some experience though. I've known a lot of EMTs whose first and only job ever was in the ER though. ER jobs are excellent "exposure," but usually not really quality "experience" for an EMT. The wholistic exposure to the diagnostic process and the therapeutic continuum are invaluable to your professional growth. You simply can't get that kind if experience in the field, even in a busy ALS system. On the other hand, the "experience" you get in the ER is usually negligible. EMT is just first aid. There isn't much first aid given in the ER. Damn few of the so-called "skills" you learned are applicable to definitive care. The bandaging and splinting you spent so much time on in EMT school is all but useless in the ER where it's all about dressing and casting, which are completely different skills. The result is, when you get to the field, you'll be way ahead of your peers in patient evaluation skills, but way behind in your B&S, etc... Not a bad trade-off though, as far as I am concerned. Anyhow, if EMS is what you want to do, then ER is just going to frustrate you because you won't be doing anything you were trained to do except taking vital signs and occasionally performing CPR compressions, which any monkey could do. And even if the nurses treat you well, you're going to feel crapped on because while they are doing patient care, you are going to be cleaning beds and emptying trash cans. A nurses aid could do your job, and in many hospitals, they do. And they have more training for it too. That perspective kind of wears on you after awhile. That said, if you can find a hospital-based EMS service, it can be the best of both worlds! Good luck, whatever you choose!

LOL! It's a Russian made AK-47. We see quite a few different variations out here, depending on where you are. If you look at a formation of Iraqi soldiers or police, it's not often you'll see two guys in a row holding the same model of AK. The Iraqis themselves made a pretty decent version, which has a vertical hand grip that is part of the wooden forestock. It is becoming the most common version out here. We also see Egyptian versions. I like the Russians, personally.

Again, this is all quite situational. As OveractiveBrain pointed out, to say that one is always done before the other is strictly "cookie cutter" medicine for amateurs. Sure, on somebody that presents overtly with an unstable or otherwise strong cardiac picture, we need to get a lifeline immediately. No question about it. But unfortunately, few of our patients are that cut and dried. The vast majority turn out to not be cardiac in origin at all. They have GERD, pneumonia, pectoral muscle strains, arthritis, indigestion, pancreatitis, anxiety, hyperventilation, and volumes of other potential maladies that aren't serious enough to warrant a lifeline, but still give you a few minutes of concern that warrants a diagnostic EKG to make sure you aren't barking up the wrong tree. And again, in that vast majority of cases, the EKG is where I would start. Yeah, I guess if you are a n00b or a wanker, it sucks to figure out that your patient just has a muscle strain, thereby missing your opportunity to start an IV on somebody who didn't need it, but that's life as a professional. Nobody promised you a rose garden.

Well, if you are not discouraged from continuing your dive, I hope you will strive to become the quality of provider that raises the value of our profession so that the next generation will have things a little better than we do. That means another two years of school for you though, at the very least. Good luck! Thanks for accepting my response in the helpful manner in which it was intended. Love the avatar pic! :cat:

Exactly. Now it is all starting to make sense.

I've had friends struck and killed on MVA scenes. I've been struck once myself. I've had my vehicle hit at least four times, but who's counting? I don't know how statistically common either actually is, but I do know it happens too much. And I know that it happens a LOT more often than all the other violent dangers that EMTs seem to worry about so much.

As opposed to what, car fires? Do you really get dispatched to car fires? :? Your anecdote about the guy collapsing at the fire is about as worthless as those stories we hear about how you should never wear seatbelts because you "might" be trapped underwater. There was just as much chance that somebody would have gone down on the opposite side of the incident as for him to go down in front of you. Dumb luck doesn't make for good statistical science.

I still don't understand. :? She is already IN THE U.S.A., right? So then, what is this "border zone" and "check point" she is worried about?

I agree that this is a situational question, depending upon patient presentation. Somebody who is truly sick in appearance will get an IV first, worrying about narrowing down the diagnosis later. However, on the vast majority of patients I will get the EKG first so I have a clearer picture of where I am headed with my plan. Where I work, I usually have no partner. No medic. No nurse. No doctor. Not even a lowly EMT-B. Just me. Consequently, I have to do everything myself, meaning I have to prioritise more than somebody with a partner. Again, the great majority of the time, I get the EKG first, right after vital signs, and then move on to establishing a line, if necessary. Obviously, I am getting the 3 lead while I am hooking up all those other leads. And if there is something life threatening on the 3 lead, I can move directly to any necessary interventions at that time and worry about the other 9 leads later. But, as correctly stated previously, the IV is not (usually) a treatment. It is just a means to an end. And this early in the game, you don't even know that you have an end to reach.

Ditto to the preceding kudos. Job well done. I am glad that you weren't stuck there alone waiting for the closest EMS, coming from 60 miles away. I suppose the only criticism I would offer would be that you "ran" up to the vehicle. If you meant that literally, I would encourage you to stop and take a deep breath in the future before approaching the scene. Sounds like you did have safety in mind, and that is great, but have it in mind from the very beginning, not just after you reach the car. Dangers exist on the way to the car also, so again, slow down, take a deep breath and a look around you before you approach your patient, and then walk quickly to their side, but do not run. Running is just something we do on "Rescue 911" re-enactments, not in real life. Welcome to the dark side!

Apparently I am the only one, but I can't get past the premise of the scenario. The mother is IN THE U.S. She wants you to take her and the child to a hospital IN THE U.S. Is this a correct interpretation? If so, in regards to the Border Patrol, what exactly is the problemo? And is she hott?

If she has Cullen's or [Grey-]Turner's, alert the media! What was that meal she had at 1800? All my differentials have been covered here. At first I thought about PMC, but with normal BMs, that's not at all likely. It's probably going to take labs and an ultrasound to get a handle on this one.

Okay, let's put this absurdity into perspective: You meet a really hott 10 year old, and you want to have sex with her. Of course, the law says no, but you know how to do it, she really wants it, and her mother tells you it's okay. Is it okay? End topic.

And then there is the real world. You WILL get fired. It will be for being five minutes late for work (even though you weren't), or for not pressing your shirt well enough, or for an anonymous complaint from a nursing home employee, or for not cleaning your truck well enough, or for leaving two sheets but only one pillow case for the next crew, or for forgetting to dot an I on a run report. There won't be a thing in writing about it being related to your fraud complaint, but we all know that it really is. And the government won't even attempt to do a thing about it. And you can't afford the attorney to fight it. And would you really fight it even if you could afford the attorney? Sorry, kids. This is a lose-lose situation. If you honestly believe otherwise, then you don't want to hear what I have to say about Santa Claus.

Ditto. I've always used two or three inch cloth tape on my thigh for note taking, for as long as I can remember. On a monitored patient, I will (if possible) jot my vital signs and drug administrations down on the EKG strip so that it is time stamped and you can compare the intervention to the rhythm. Makes recalling what you did on a 45 minute CPR a lot easier! I can't really see any advantage to using a specially made sticker for the purpose, unless you need something with pre-printed prompts on it to remind you of the examination sequence or something. And that's not anything you'll need for very long, unless you are in a VERY slow or very unsophisticated system.

There's a ballpoint pen next to the Sharpie. The little black thing is a small LED light with a bulb colour appropriate for whatever aircraft I am most likely to be inside. The blue thing is a Carpuject syringe for morphine. And the carabier/snap link is primarily for hanging my helmet on when I am not wearing it. It also doubles as an attachment point for a rescue line. You'll see a lot of soldiers and marines with them on their shoulders, and they put their rifle slings through it. It works better for some than slinging your rifle over your shoulder, and it keeps you from losing your weapon. Okay, so as you can tell, I am back from vacation! Consequently, I don't really have any new Iraq pics except for this one: I went back and got a pic of me with the Saddam shrine just in time. They painted over it about a week later. It was the last one left here.

LOL! You read my mind. I actually considered going back and editing my post to include that idea, but I figured I'd save it for later if I needed it.

Did OSHA and the NFPA misspell "occoupation" (sic) too? Here's another fact for you. Old age kills a LOT more people than fire, smoke, and carrying 60 pounds of gear combined. There are a lot more old people at a geneology conference than there are firemonkeys dropping at a house fire. A lot more taxpayers too.

Exactly. WTF makes 20 firemonkeys so special that they deserve any more consideration than 3000 Mormons at a geneology conference? Somebody is a little full of themselves. What are they, 5 year olds who need their hands held while they squirt water?

That right there is proof of a failure of the Incident Command at that scene. And those are the guys you think ought to be telling us where to deploy? Firemonkeys are obviously incapable of deploying their own assets competently. Proof positive that they are certainly not the best people to determine how EMS deploys their assets.

LOL! Y'all misunderstood me. I wasn't criticising the use of the KED. I was criticising the NON-use of the KED. EMS_GIRL was saying that the only time they use the KED in her agency is for wheelchair patients, and that they never see the light of day on MVAs. So basically, these guys are really impressed with themselves for thinking of using a KED on a wheelchair patient, but they are too stupid, incompetent or lazy to use the KED when it is actually indicated. That is the point I was getting at. Sorry if my point was not clear.

Plus 5 for that final quote, DT. :thumbright: Two out of six could have been prevented by simply keeping your doors locked. The simple, common sense act of locking the ambulance doors results in a thirty-three percent reduction in violent injury. Sounds like a no-brainer to me. Prevention is the best medicine and negates the necessity to learn "defensive tactics" that you will never remember or successfully pull off in a crisis. ALL doors locked at ALL times. Period. No exceptions. No excuses.

Accredited by whom for what?

Akroeze is correct. We don't go looking for victims. People call us when there ARE victims. And the one place they will expect to be able to find you is at your truck. Nothing pisses people off more than to run to the ambulance only to find it locked, and the crew several hundred yards away, wanking at the pretty flames. Never leave the boat. Never leave the boat. Never leave the boat.

Did you really not even bother to ask this question before you took the class? :? Did you go to college without first finding out what a computer office professional makes for a living too? I bet not. But seriously, what were you expecting? Were you expecting somebody with a 3 week first aid class (which is all EMT school boils down to) to command the same salary you get with your degree? If you are serious about helping people as a profession, have you considered just going straight to paramedic or nursing school? They actually help people AND make a living, in most cases. If you were willing to invest in two years of education to be a secretary, I would expect that you are at least as committed to being a professional medical provider, and not just looking for a quick way in. I wish you good luck, but there are many MUCH better ways to help people than by being an ambulance driver. And most of them actually pay you a living wage.