Dustdevil

LMAO! That's funny right there! I don't care who you are!

I think if we were to look at the real statistics, most of us would find that the most common "call" in our systems are wrong numbers and 911 hang-ups.

Cool! Good programme there. The new (well, almost ten years old now, but still new to me) performance hall is awesome.

Are you an EMS student at WC, or something else? If so, who is running the EMS programme there now? WC had a pretty good EMS programme for many years. The first director was a medic I worked with in the 70's and 80s, and was one of the smartest medics I ever knew. Had a degree in chemistry that served him well. The guy who took over when David died was a medic I worked with at Parker County in the early 90's, and he too was a pro. Not sure who took over after Steve was killed, but I know I ran into a couple dozen of Weatherford's medic school grads in a refresher two years ago, and they were all there because they had failed NR three times and still weren't registered. Sounds like the programme has gone way downhill in recent years. I hope it is getting back on track.

If you are a long-time, experienced medic needing a review, that is a good resource. But if you are learning drugs or anything else for the first time, I would avoid that site -- and any other resource that gives you info without having to look it up for yourself -- like a plague. It will cripple your education. The primary educational value of flash cards is the learning you achieve by looking up the information, transcribing it by hand, shortening it into bullet form by hand, then writing it again on cards. That process is what burns the info into your brain. Simply reading what somebody else wrote over and over won't do it. Look the info up in a PDR or some other COMPREHENSIVE resource. Read ALL of the information for that drug. Don't just read the indications and dosages. Read ALL of that information so that it is presented to you in full context, enhancing your understanding. The point is to learn and understand pharmacology, not to just memorise drug indications and dosages that fit neatly on a 3x5 card. Forget the shortcuts. You're only shorting your education.

A frequent problem with the use of the Miller is exactly what you are seeing. People have a tendancy to go in too far, yet still think they aren't deep enough and adjust in the wrong direction. But the beauty of the Miller blade is that you don't have to be as careful about where you insert. Go deep, then slowly pull back until you visualise the cords, and voila! Conversely, with the Mac, you have to be in the right place from the beginning, or else end up doing a lot of back-and-forth positioning. I'd stick with the #3 on most patients (if not a #4), then just go with the above technique. The bigger blade tends to keep more tongue out of your way, and it also gives you more blade to use should you end up having to use it Mac style in a pinch.

LMAO!! Excellent point, Deano! This is what happens when somebody watches a couple years worth of Turd Watch episodes, and then thinks they now have two years worth of EMS experience.

I went the Do It Yourself route, since out here you are never sure how long you will remain at one camp. Not to mention the frequency with which phone numbers are changed in military offices. Consequently, I never print up more than ten or twenty at a time. And, of course, it is cheaper and looks as good as professionally printed cards if you do it right. I'll scan it if and when IT ever gets me hooked to the scanner here, possibly today. I too was going to recommend just bagging some of your boss' cards, then jotting your name down on the back. As Mike said, this is a good way to assure that such letters hit their intended target. Otherwise, you look like a tool taking the letter that was sent to you into your boss looking for brownie points. For the average EMT or medic, there is really no particular need for cards. But there are certainly lots of good uses for them, besides for scribbling notes on. If you get into the con-ed circuit and attend conferences and conventions, you will meet a lot of people that you would like to keep in touch with in the future. Networking is important to career development. Having a professional card to exchange with these people is a very good thing, and is good for your image.

Fine advice. Listing it without trying to tout it as actual employment is a good way to go. Sorry, but as one who has done plenty of hiring in EMS, I disagree. These are businessmen we are talking about. Managers and entrepeneurs. What they would be impressed by is the professional maturity of understanding and respecting their business as a business, and not a hobby. When you cheapen your services, you cheapen theirs too. You are devaluing their business by proclaiming that it should be provided for free. How can you insult somebody's business and profession and expect them to be impressed by that attitude? I know you have taken psych and sociology courses, Man. Put some of those concepts to use here and try and understand how a BUSINESSMAN thinks, not how the average EMT thinks. These are not average EMTs doing the hiring at most places. And they certainly don't think it is as awesome cool to be a whacker as you do.

Dude, you come up with some of the best advice! Plus 5. :thumbright:

Geeeze... what is this, national Put Words In Dustdevil's Mouth Day, or what? :? Absolutely agreed. And that is one of the big points I was attempting to convey.

I believe you misunderstood me. I never said they "dont do nothing." I never even insinuated such. I know that many of them run their arses off. What I said was that giving your services away for free is not a flattering thing to say about yourself. It says that you place a very low value on yourself. And if you don't value yourself or your services, why should I? If you gave it to the last guy for free, what is my motivation to pay you for this? This is how logically and professionally thinking adults think. And, if by chance your prospective employer is such a person, this may affect your chances adversely. Sure, they don't expect a kid right out of high school to understand this, but it is impressive if you do. If you present a lower key, less braggadocious attitude to your potential employer, it will reflect positively on your maturity. If you want a real job in the adult world, you will do well to present a mature, adult demeanour. It is hard enough to get an EMS job atg your age as it is. I also tried to make the distinction between applying for a real EMS job and applying for a non-EMS ambulance job. Sice you have not yet clarified that for us, I tried to cover both scenarios for you. I apologise if that was confusing. As JP said, CPR is not rocket science. Your dubious claim to saves may impress the girls at your high school, but to a professional medic who is interviewing you for a job, it is not particularly meaningful. Yes, it says that you have seen enough real action that you probably won't lose your lunch on a scene and quit in the middle of a shift, which is certainly a good thing. But, other than that, it says little. It doesn't say you are any good. It doesn't say that you are cut out for the business. What it does say, in addition to the low value you place on your services, is that you probably picked up a lot of bad habits that your new employer is going to have to spend time breaking (like not using KEDs because the losers you work with convinced you it was not necessary, despite their ITLS and PHTLS training). A great many employers, myself included, would much rather take a fresh out of school newbie and indoctrinate them professionally than to have to re-train somebody who thinks they have so much experience that they already know everything. And frankly, true or not, your claim to twelve CPR saves on a BLS volly squad sounds very much like a BS story, which will immediately turn off a potential employer. You asked what employers look for, and that is what I am telling you. Sorry if it doesn't fit with your 17 year old view of what looks good, or what other EMTs here who have never been in management think. Sure, there are a lot of unprofessional and uneducated idiots in EMS management in this country, and they may think differently than me. But if you are looking for employment with a professionally managed agency that is actually worth working for, I urge you to give careful consideration to my advice. And again, good luck.

The very first lesson taught in any survival school worth a damn is PMA, which is Positive Mental Attitude. If you can find ways to stay positive minded, your chances of survival -- or at least comfort -- increase dramatically. I taught aircrew survival for the Air Force for some years. When assembling items for individual survival kits, we always had long discussions regarding the usefulness of each item. The military has carried condoms in these kits for decades now, and inevitibly, my classes would mull over the possibilities. Primarily, they are useful as water carrying bags, but they are also useful for constructing a slingshot, making a tourniquet, or for placing items into to protect them from water. However, once all that was covered, I always reminded my students that condoms in the survival kit also served one more important purpose. They are moral boosting items. Think about it. If you pull that packet out of your pocket a few times a day, look at it, and contemplate the day you will return safely home to use it for its intended purpose, you will have much to look forward to! That, my friends, is a good way to keep the Positive Mental Attitude! Of course, as SOMEDIC intended it, morale boosting also works by not just trying to survive, but by surviving in comfort! If you have some basic niceities that help you keep a pleasant routine (tea, cards, music, etc...) then you can stave off dispair for a much longer period of time than you could by only meeting your needs for food, water, shelter, etc...

Dang, Girl! You just said everything I was about to say! Especially when you asked exactly what part she was having the problem with. Although it is a short procedure, there are a lot of potential individual pitfalls along the way. Breaking the procedure down into individual steps will help you identify the problems affecting you so that you can address them effectively. For instance, if you are having trouble visualising the cords, then that is a very different problem from having trouble placing the tube. Can you tell us more specifics?

This is not unique. I have been at two of the three largest air bases in Iraq, and they didn't do certifiable con-ed for EMS either. My last two assignments have been on camps so small that we were lucky to even have a BAS, much less con-ed. I will be interested to see if others have solutions for this.

I too have mainlined Valium for seizures. Only other time I have mainlined was Benadryl for extrapyrimidal reactions, because it works so quickly and certainly that you know there is no necessary followup. Not that I am recommending the practice, but I don't see where it would be illegal. Maybe some particular state's Nurse Practice Act says so? :?

I agree that IV antibiotic prophylaxis would be indicated in the scenarios you are referring to. But I also agree that a third generation cephalosporin would probably not be the ideal choice. Back in the early 80's, before nursing school and microbiology, I was with a rural service that had IV Ancef in the protocols for open fractures, GSW's, abdominal wounds, and other dirty wounds. After doing a little basic study of antibiotics, I decided that Rocephin was a better antibiotic and brought that up to my medical director, who explained to me that I was an idiot. It was a lesson I never forgot, lol. On the other hand, out here Rocephin is our first-line antibiotic in the field for everything, simply to keep our formulary simple, while still covering everything from wound sepsis to pneumonia. Yes, it is shotgunning and overkill. But we do stupid things in war. At the MASH centres, they still use Ancef though. Anyhow, I digress. Antibiotics in field treatment are not a new concept by any means. If your GP were a surgeon, I agree that he would probably have a different viewpoint. Perhaps you can find a surgeon to be your mediator in these matters? Try and find the one who treated your friend and have a little professional discussion about the case, as well as the benefits of abx prophylaxis, then casually mention that your MD had some misgivings about it.

Hmmm... I kinda like the concept, although I have no experience with this, nor have I seen any research on it. All throughout the late 70's and early 80's, many agencies utilised shaving cream (non-mentholated, please!) to cover burns with. Saran Wrap is no crazier an idea, really. Although, I would be very doubtful that this could approach the efficacy of BurnJel dressings.

Those are still an option in the Philips, at least. I have heard a lot of the recordings and they can be hilarious. I remember one from Scotland where I couldn't understand a word they were saying because of the thick accents. All I understood was some woman who kept yelling "STOOND BOCK!!!" before each shock. The reason people have trouble with these assessments is because EMT school TRAINS you to memorise and recite mnemonics instead of EDUCATING you to actually understand the reasons and goals of your assessment, as well as the human body itself. Consequently, it doesn't really matter if they ask all the right questions because they are basically just going through the motions to hear themselves speak anyhow. They don't know what to do with the info they get from the questions. My advice is to concentrate on understanding the disease processes, understanding WHY you want to know the answers to your questions, and what you are going to do with that information. Understanding is the key to memorisation.

Yes, I am too good to do transfers, just like I am too good to clean toilets or dig ditches. You have a problem with that? So anyhow, back to the original question, this presents a dilemma. As an employer, I and many others, do NOT want to see volunteer experience on your resume. Like it or not, being a volunteer says many unflattering things about your professionalism. But, on the other hand, having been certified two years without any experience doesn't look so hot on a resume either. Therin lies the dilemma. Of course, I realise that NJ is in it's own little world and tends to see things differently than the rest of the profession too. :? What I would most like to see on a newbie's resume is education. Your willingness and ability to complete education (not training) indicates to me your willingness and ability to pay attention and learn new things. I want you to learn to work for ME, the way I want you to work. I do not want you to simply come to my agency and do the same thing you did for somebody else for free. Therefore, if you have any relevant education besides EMT school, you should certainly hilight this on your resume. Did you take Chemistry, Biology, Physiology, Psychology, Sociology, or advanced mathematics in high school? List them! Don't just list "high school" in general. Do you speak a foreign language fluently? List it! Did you serve as an athletic trainer in high school? List it! All these are things that I would look favourably upon as a potential employer. Also realise that if you are applying for a non-EMS transport position, many of them also are not interested in volunteer EMS people because they usually don't stay long and do a half-arse job because they would rather be doing real EMS. And EMS experience isn't that relevant to the transfer business anyhow, so again, consider if your volunteer experience is really a relevant positive to your employer before you emphasise it on your resume. Actually, you should consider that probably any EMS provider (as opposed to horizontal taxi service) who hires you before age 21 probably sucks and is probably not worth working for. Think about it, if they are that indiscriminate about who they hire, how much faith do you have in any of their other professional policies? Keep that in mind.

Uhhh... all that is fine and dandy AFTER you have extricated them. You FAIL to address the extrication itself. Ever bothered to read the User Manual for this device? Apparently not. This is a very poor reflection of your professionalism. And you would be fired after your very first MVA run with any professionally operated EMS agency too. It is painfully obvious that you have never worked for one, which is exactly why so many of us here maintain that volunteer experience is NOT helpful to career development. It only instills and reinforces bad habits. Not to mention that when you give your professional services away for free, it pretty well tells everybody what you think they are worth. Nothing. Do yourself a favour and take college physics before you go to paramedic school. Your current knowledge is grossly inadequate to function in EMS at all, much less at an advanced level. Do this simple test. Hold your hands out in front of you as rigidly as you possibly can. Then have somebody place a mere 2kg into your hands and see if your hands move. I can assure you they will. Now, how in the hell do you expect to hold the head, neck, and torso of a 100kg human being immobilised with those hands? The answer is, of course, you can't, which was my original point above. Having been one of the original PHTLS Instructors certified over twenty years ago, I can tell you that this is not new information. It has been a scientific and professional standard since before you were born. I don't know wtf they taught at your ITLS class, but either the instructor sucked, or else you are a poor student. Or just a lazy cowboy. Or all three.

Good advice from CJ, as usual. As you should have been doing throughout school up to this point, focus on the headwork, not the skills. The skills are easy. The hard part -- which a great number of medics never master -- is assessment and diagnosis of your patient and his/her problem. Don't count on a mere 250 hours getting you there, especially if you don't have the educational foundation that a quality programme provides, but it will certainly go a long way towards helping you to function professionally. Again, forget about skills. If you need them, you'll use them, and you'll get better with each patient. But this is not a "goal" you can or should set. It is simply natural progression that results from practice. If you focus on skills during your Internship, you will be shorting yourself and your patients. Way too many medics do this, and it shows. You can't approach your patients with the sole intent of figuring out what skills you can (as opposed to "should") use on them. Your primary focus should be a complete and comprehensive diagnostic evaluation of their condition to determine what their problem is. Then you identify what specific problems result from this condition. Then you identify why those problems exist physiologically. Then you identify what interventions you might perform which would improve these conditions. There is only one skill in your repertoire that should be constantly in the forefront of your mind and priorities, and that is assessment. Everything else is a distant second at best.

Okay, perhaps I was not as clear as I meant to be. I did not mean to say that adequate immobilisation cannot be achieved without a KED. What I meant to say was that it cannot be done manually. It will take some sort of rigid immobilisation device, such as the KED. You absolutely cannot adequately immobilise a patient being extricated with your hands alone. That is chisled in stone. I see no room for intelligent dispute of this fact of simple physics.

The answer to this question is always "no." It cannot be done. Period. And anybody who thinks they can is an idiot. A dangerous idiot. But yeah... this does go back to the question of whether or not this was a time-critical patient who warranted a rapid extrication or not. If so, you did fine. If not, please ignore the losers you are working with and insist on proper extrication in the future. Good on you for looking back on your runs and critiquing your performance! That is a very mature and professional thing to do that puts you ahead of many in EMS.

How about we just lower the age of consent? People are being arrested and convicted everyday for something that isn't even a crime one state line or national border over. If our laws were in line with those of our neighbouring North American countries, the occurrence of this "crime" would be cut in half. There now, wasn't that simple? :wink: