Dustdevil

That is my observation in North Texas too. Those who find jobs seem to easily pull in six figures early on. Although, it seems that there is a disparity between the grad rate and the opportunities available to them. I think a good many of them end up having to move to find a good position. I too have lost a lot of the admiration I once had for PAs. I once thought that PA was the way to go, and thought they were awesome. But over time I have seen far too many of them working over their pay grade and making boneheaded mistakes. I recently took a dyspnea patient into the ER with acutely exacerbated COPD bronchitis and an infiltrate. The PA for some reason got all focused on the patient's tachycardia and BP of 150/91 and started calling for beta blockers. Every nurse in the room -- including the lowly 22 year old Ensign -- quickly got this look on their face -----> :shock: On the other hand, I have never had anything but great experiences with NPs of any specialty. I find them a lot more wholistic (not to be confused with holistic) in their approach to the patient, while, as Rid said, more focused in their understanding. It seems clear that while a PA receives a broad foundation, it is not built upon until well into his career, through personal focus. NPs come out of school more ready to apply what they have learned in independent practise.

We need a thread on handling bariatric partners.

I can add nothing to that. In fact, it needs nothing added to it. It is spot on, word for word. SOMEDIC, not only was your attack totally off the mark, it was shockingly lacking in class. The measure of your manhood will be what you do to redeem your credibility here from this day forward.

This whole "WE DON'T DIAGNOSE!!" mantra is a tired old bag of dinosaur bones left over from the early 1970s, when no paramedics were educated to a level of competency where they could differentiate between one tummyache and another. When all dyspnea was the same. When we were merely the eyes and ears of the medical control physician, and nothing more. Although that culture persists in many regions today, we are finally starting to move solidly away from it towards an era of professional medical practise, where paramedics will be educated to do rudimentary diagnoses, as well as prescribing specific short-term treatment instead of just giving every tummyache an IV and oxygen. Continuing to to parrot that old line doesn't ingratiate you to those of us who were here when it was true. And it certainly does not bode well for your potential to be a part of the future either. It is time to either get on board with the future of EMS or to get out altogether.

Unfortunately, they can and will do this for one simple reason; because they can. This is the very same reason that so many communities with financial resources still run volunteer EMS. So long as people with no pride or professional options will work for free, there will be people who will "employ" them for free.

LMAO!! I ain't touching that one!

All day. Everyday. If all I could do was take people to the hospital and tell the doctor, "His tummy hurts," I would rather work at McDonalds. I prescribe too. One without the other is kind of pointless. Am I comfortable with other medics doing so? Damn few of them! In general, no. But, as Rid said, the profession certainly has the potential to progress towards that ideal if they ever get the firemonkeys out and up the educational standards to professional levels.

I wouldn't say that was an "old fashioned" idea. I would say it was an idea that was never utilised in the first place. In over thirty years, I don't recall ever working anyplace in EMS, clinical, or hospital medicine, where the quality of your job performance was the overriding factor in your success. It's all about the politics. And the Peter Principle is alive and well in EMS.

Exactly. The first and biggest mistake here is the assumption that the symptoms have anything to do with the lipo or the medication, and that any EMT has the clinical sophistication to determine that. I can assure you that the ER will not make that assumption until a proper physical examination and laboratory has been performed. And even then, they will sometimes be wrong. Your partner should be fired and reported for decertification. Your agency should initiate strict educational and operational standards to prevent this from happening again. Definitely. Excellent point. But since it still happens so frequently, it is certainly still an issue. I can think of several reasons why: 1. EMTs are inadequately educated for the job tlhey are performing. 2. EMTs are, to an alarming large extent, too stupid for the job they are performing. 3. EMTs are, to an another alarmingly large extent, too lazy for the job they are performing. 4. EMTs are, to a huge extent, disenchanted with the job they are performing because they aren't getting the constant adrenaline rush and blood and guts and action they saw on Turd Watch which caused them to go to EMT school in the first place, so they take it out on their patients. But yeah... he should be fired.

Plus 5 for an incredibly informative and relevant post! Good luck getting the wankers to play along though. I don't know how many times I have cut down to just my rear ambers at a scene, only to have my wanker partner run back and turn all the lights back on while fetching equipment. Even on a dead end, residential cul-de-sac in a gated community. :roll: It will take official policy and a few firings to change things in EMS.

Age, allergies, PMH and meds I write down with vitals on the tape strip. Signs and symptoms, I memorise. If you are doing a methodical history and physical exam (as opposed to haphazardly), memorisation is easy. We obviously don't bill anybody out here, so I don't have to get insurance info and such. But back in the world, I get that info and other demographic info at the hospital as the patient gives it to the admissions clerk. Why make the poor old lady answer the same asinine questions twice? Of course, it is different in the IFT world, I guess. You are sitting and staring at the patient, doing nothing for half an hour. You might as well be doing the paperwork so you can get clear faster. Besides, you're not usually getting bloody on an IFT or anything. More than half the time, you never even touch the patient.

I'd be shocked if more than five percent of those who offer an opinion have actually used both models enough to judge. People just go with what they know and stick with it. Otherwise, Lifepak would have gone out of business a long time ago.

First time I remember seeing or hearing about the Datascope MD3 was 1979. I believe that was when it was introduced, or possibly 78. Sweet! I was using the 360 by the mid 70s, and I believe the 450 came out around the late 70s. That's about all I can tell you about those. I didn't used them long as we replaced everything with LP5s by 79. Which model? There was the Motorola COR (orange box) which came in at least two different models (5 channel and 10 channel), and the Motorola APCOR (white box) which was all 10 channel and came in several models, shorter or longer than others. And, of course, there were other manufacturers of biofones too. I think I have one 5 channel COR and one 10 channel COR at home.

Who the Hell is/was King Drew? :? Is he related to Rodney King?

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

Thank you for being a good sport about it!

Oh puhleeze... what do you know about trailer parks? You don't have trailer parks in New York. Otherwise, you'd have tornadoes in New York.

Have you read the thread?

Before you even try, I recommend you get an interpreter. They don't speak English up there. :?

I have noticed that the majority of time when I see somebody driving like an arsehole, they either have disabled plates or a Texas A&M University sticker (or plates, or both) on their vehicle. What's that all about? Do the disabled drive like arseholes everywhere, or is it just a Texas thing?

Absolutely! That is exactly why we are qualified to give such advice. Been there. Done that. And you, Grasshopper, are not yet ready to leave the Temple.

Exactly. Without documentation, you have no way of doing QA. If your agency is not doing QA, it sucks.

I do that on every single patient. It's the only way to avoid having to handle that piece of paper, keep it handy, and not end up wondering where that little piece of EKG strip with all my vitals on it went. I don't even touch the clipboard until I have already delivered the patient to the ER and washed my hands.

....... bad subject line .......

I've never worked any civilian EMS position where physician extenders were in a position of medical control. I can't say that I am totally opposed to the concept. I currently rely quite a bit on PAs for medical advice in my clinical practice. I run into some PAs that honestly don't seem to know anymore than I do. But I also deal with quite a few PAs that are extremely knowledgeable and are outstanding in a particular specialty. Let's face it. Pre-hospital EMS is not rocket surgery. I can think of damn few situations where a reasonably competent and experienced PA would not be capable of providing quality medical control to EMS. In fact, I can think of damn few situations where a reasonably competent and experienced paramedic should even need medical control in the first place. But, as Rid stated, a Medical Director is, by definition, only a physician.