Dustdevil

I am no expert on the jurisdiction of the DOT and NTSB, but I have done a lot of work with them both in the past, and it seems to me that this may well fall under their expanded scope, seeing as how there was indeed money exchanged in this deal, albeit from the city to the squad. I would think that the NTSB would less likely to be so kind with their judgment in this matter. Probably also not too pleased that they were not notified of it in the first place.

Well, we called BS on your assertion and you conveniently failed to address it. You speak of this new breed of educated paramedics as if you have a tonne of experience with them. Sorry, but I very seriously doubt that you have worked with enough of them in Chicago to even know what you are talking about. You're just making ASSumptions that fit into your comfortable little niche. You also appear to be intentionally confusing two very separate issues: education and experience. Your assertion that experience trumps education is a logical fallacy. It ASSumes that the two are mutually exclusive, which they are not. Nobody here is arguing against experience. We are merely saying that experience is a much better tool when it is preceeded by a sufficient educational foundation. In other words, you cannot compare somebody with four years experience to somebody with four years of education, because that is not the argument. To make an honest and intelligent argument (which you are failing miserably at), you have to compare somebody with four years experience to somebody with four years of education AND experience. I challenge you to show me that the one with education is going to be less proficient than the one without. One thing that I think we may agree on is that education must be QUALITY education. From what I see of most EMS associates degree programmes, they suck. Their course load is poorly chosen and inadequate. That is where national standards must be implemented, as the NLN does for nursing schools. Simply having paramedic school and 30 extra hours of nonsense does not necessarily make a better medic, I agree. But you cannot intelligently making the argument that somebody with just a 6 month paramedic tech school is as well prepared for practise as somebody with that same training plus a year of anatomy and physiology, microbiology, chemistry, algebra, psychology, and sociology. And trying to do so just makes you look like an idiot.

I'm with you on the idiot cop thing, Marty. That sort of macho $hit nonsense is one of the main reasons that I was disgusted with law enforcement. More cowboys in police work than in EMS, and that is pretty bad! And the bigger an arsehole you are, the more you get ahead in law enforcement. And what difference does it make what sort of arsenal the guy has at home? It ain't like he had an AK47 under his t-shirt. It will take one of those offenders mowing down a few cops -- or camera men or bystanders -- to get them to stop that stupid showboating for the cameras and go back to tactically sound procedures. Until then, they are a disaster -- and a lawsuit -- waiting to happen. They are already suing one city for allowing these stings in a neighbourhood and a gunfight breaking out. It's only a matter of time before cities get too liability conscious, or somebody gets killed, and all this stops.

Yeah, I dunno where this D.O. vs. M.D. tangent arose from. :? Some of the best ER docs I have ever worked with were D.O.s. Best medical director I ever had was a D.O. Best dermatologist I ever met was a D.O. If it weren't for D.O.s and their commitment to primary care, there would be a lot less people delivering babies today since a great many M.D.s are bailing on OB wholesale. And, of course, let's not forget that the man who wrote the best Paramedic textbook on the market, and who is fighting as hard as anyone to advance our profession, is a D.O.

I had to vote "not lately." I am pretty sure that there is no offender registry database in Iraq. Of course, there are no children on any of these bases either, so it's not a significant problem. Although, one must remember that, despite the best disinformation campaign of the media, not all so-called "sex offenders" are paedophiles either. In many states, simply pissing on the side of the highway makes you a "sex offender."

Other than a good flashlight, there really isn't anything you need that your employer shouldn't be providing you. And the better employers will provide the flashlight too! I recommend the Stinger. I specifically recommend against full sized MagLite type lights that can be mistaken for weapons. Good safety shoes or boots are also highly recommended, but that is something you need to choose by actually wearing them yourself. Anything else, you either don't need or your employer sucks. If you want to excel in EMS, your smartest move would be to come to embrace it as a medical profession, and not "public safety." The most important piece of equipment you can have is something you already have between your ears. Exercising your brain with constant education (not to be confused with training) is your best preparation. All of the other accessories are useless without that. Good luck!

Oh wonderful. Yes, making predators even more angry and anti-social than they already are certainly sounds like the answer to all of our problems. :roll:

I did understand that. That is what I was commenting upon. They seem intent upon fragmenting the system into separate entities for treatment and transport, instead of having one organisation handle it all. There is absolutely no reason or justification for that sort of idiocy from any logical, service oriented standpoint. It contributes nothing positive to the delivery of EMS to the people. The only thing it contributes positively to is the image and budget of the fire service, which is really what this is all about.

But seriously folks, can this really be about keeping costs down? I ain't no mathmagician, but I am pretty sure that simply providing enough ambos and paramedics to meet the demand for medical services is, in the long run, much cheaper than what it costs the FD to run this dual role nonsense. It's not about saving money. It's about milking money and glory for the fire department because really, they aren't worth what they are getting as it is, much less if all they did was supression.

That is also why medics have to spend hours offloading their patients in Ontario. No out-of-pocket expenses equals no inhibition for people to tie up the ER for total BS that has no business there. Maybe it's just me, but I don't see how paying significantly more for healthcare is a significant benefit in exchange for not paying out-of-pocket.

Funny how this always comes from somebody who doesn't have the education themselves. Tell us, just how many degreed medics have you worked with that you can be so sure of this nonsense you spout?

Can you qualify what you mean by "good experience"? I suspect that only means you are having fun and don't want to quit, and nothing more in a real, valuable sense.

High taxes in ON pretty well negate any significant salary differences for most of us, especially those of us in tax-free states. That is a pretty big factor to take into consideration. While I disagree with the whole "why would I want to go to more school to do less?" argument, I have to agree with the "why would I want to go to more school to make less argument.

What is your educational preparation? Do you already have two semesters of A&P, Microbiology, Chemistry, and Algebra out of the way? If not, there ya go. It is practically unheard of for somebody with the proper educational preparation to fail paramedic school. And if your school does not require those prerequisites, then your school sucks. If you have completed those prerequisite courses and are still having trouble, then I agree that distractions seem to be a major part of the problem. Perhaps you didn't have all that going on a couple of years ago when you took the prerequisite classes. I would also agree that you need to divest yourself of some of those distractions before trying again. I would specifically dump the EMT job, as that is the biggest problem, without a doubt. It gives you an uncertain schedule, the stress of a new situation, and money problems all at once. You don't need ANY of that! And the "experience" you are getting is worthless in any practical sense. You might also see your doctor, tell him of your distractability, and see if Adult ADD treatment may be right for you. It is a very real problem, and treating it may be your ticket to success. You are on the right track by attempting to take control and responsibility of the educational process. Clearly, you cannot rely on medic school to teach you all of this. You have to learn it, and only you can do that. Good luck!

Dustdevil grins as Emilea waves adios to her PA-C dreams. Time to change your screen name to another presumptious misnomer.

Plus five for a great post. I think you just said more to put the job into true perspective than any of these shake 'n bake "tactical medic" schools ever do. It's about TEAMwork and being there for your team. All that other GI Joe stuff is just television bollocks.

Anybody who thinks fentanyl causes less hypotension, respiratory depression, and sedation simply isn't giving enough of it. 8)

Do you ever intend to upgrade your education, or are you through with all that book learnin?

Nope. But that is not the scenario you presented. This is no longer about urban vs. rural. This is about ALS vs. BLS. And I don't care how long you are performing BLS, whether it be 5 minutes or one hour, it is still the lowest common denominator. After the first fifteen minutes of BLS, you have done it all anyhow. What other experiential value is there to now staring at your patient and doing nothing for him for the next half hour? None. All it does is show you that really, in the grande scheme of things, you bring nothing to the table as a BLS provider, especially in rural EMS. Go ALS or go home. Quit screwing your community.

LMAO! That's beauty! And oh so appropriate for the disasterous turn this thread is about to take.

No. I don't like the cold. I don't like working for the government (yes, I know it is ironic). I don't like high taxes. I don't like socialised medicine. I don't like gay blue uniforms or reflective stripes. I don't like large, cumbersome systems and the bureaucracy that comes with them (centralised testing). Other than that, Ontario sounds great!

I think your thinking is back asswards. Why should we dumb it down to the lowest common denominator? Wouldn't a better solution be to require that those rural services upgrade to at least the 20th century standard?

That's exactly my point! If it doesn't matter, why are you so firmly convinced that those who attempt to be more accurate than you are wrong? I'll tell you what this is all about. Most every EMT-B class I have sat in on or precepted students from had some low-time, undereducated instructor who told them all the same worn out old line about how they would be "wrong" to give an uneven BP reading figure. Nobody ever questioned that instructor, just like he never questioned his instructor before him. And it's a good thing, because none of them had a clue why it was "always that way." The fact is, there is no reason. It's just another one of those stinky pieces of feces that has been passed through the generations without any evidenced based rationale. It's time to stop the madness and worry about more germaine issues than people who want their numbers to be more exact than yours. If somebody wants to parse the numbers and split the difference, what business is it of yours? One point makes zero difference in my patient care plan. When it comes down to it, you're not telling people how to do it right. You're just telling them how to do it your way. Leave it be. Go spend some quality time with your new Galls catalogue instead. NOTE: The terms "you" and "your" in the above rant are not meant to address any specific person, but to address all those who somehow think this issue is even worthy of discussion.

Actually, Thomas Dick is his real, given name, but he only uses it while writing. He changed his name to his wife's maiden name, which he uses in his personal life, because he didn't want his kids going through the same crap he got while growing up. Truth is stranger than fiction! Thom is good people.