Dustdevil

They can't afford me after all the money they blew on the Big Dig. Besides, there ain't enough hott chicks in Mass to draw me back there.

And if your Medical Director did not call you in and ask for answers to those very same questions after this run, your system sucks.

I know everything I need to know about you from your own statements, including this one: You have no respect for the profession. It is just a "vehicle" for your own personal fun and games. You cannot possibly be surprised that people judge you by statements like that.

Dude, ragging on somebody's avatar photo is really juvenile.

Personally, I would have given up the job as soon as they told me that I would have to watch closely while people peed. :? It's a moot point. After a week, it won't show in his system anyhow.

Hell, I made a narcotic overdose medication error just a month ago, with thirty years in the field. It happens to us all eventually. That is why we are ALL students, for the entirety of our careers. We're no different from you, Kelley. It's all in your attitude and mindset. You seem to be looking at these situations as some sort of test or exam. They aren't. They are just more of the same education you have been doing so well at up til now. It's just a different classroom and a different instructor. That should be your attitude, and that should be your preceptor's attitude too. Go for it! Good luck!

I have seen that site, but I haven't seen that bag in use yet. It certainly appears to have utilitarian functional potential. Looks about the size of the old M5, which I liked, with some minor complaints. Neither the M5 nor this bag appear to be built for comfort, that's for sure. But I like the zipper layout of this bag much better than the M5 which was a major pain in the arse, as were the straps. I like that you can access this bag while wearing it, as opposed to having to take it off and lay it down. Looks like it would be a good, HSLD aid bag for those out in the field.

Sounds like wonderful standards from a state that doesn't have a single accreditied paramedic school.

Come on, Man. You know me better than that. And I know you better than that. I was just joking, as well as trying to motivate people at the same time. If I wasn't trying to be helpful, I wouldn't have bothered to find that for you. And by the way, I just now registered myself. :wink:

Has this inspired you to put your nose in the books and start learning the subtle differences in presentation between appendicitis, cholecystitis, diverticulitis, pancreatitis, peritonitis, hepatitis, salpingitis, gastritis, and PID? Don't blow it off. When something catches your attention long enough to ponder it, pay attention to that little voice that is telling you, "Hey, maybe I ought to learn more about this!" Do it while it is fresh in your mind. That is how you become better than the average medic. Good luck!

"The Canadian C-Spine Rule versus the NEXUS Low-Risk Criteria in Patients with Trauma" http://content.nejm.org/cgi/content/full/349/26/2510 You may have to register (for free) to see the entire article. But if you aren't already registered at NEJM, then you aren't very serious about medical education anyhow. It is very much worth it. The above article lays out the criteria of both protocols and compares them for accuracy as predictors. The results, in a nutshell are: Canada wins again.

Thanks for reminding me why I do not, and have not for decades, work in a system that utilises basics. The extreme disparity of education and power produces these sort of issues that you are having. And the reason you do not post lists of ways to get along with your partner is because you lack the qualifications for anybody to ask you in the first place.

With what? Jumper cables, Bic pens, and a Swiss Army Knife? Who are you, McGuyver? :?

Absolutely! That is what lead me into Respiratory Therapy. It didn't take me long to realise they were the sharpest people in the hospital, with the education most relevant to emergency and critical care. Heck, you may discover that microscopes and Petrie dishes are the coolest thing ever and decide to go off into microbiology. I've seen ER experience turn people both towards and away from medical school, so that can go either way for you. But the best thing it can do for you is to simply encourage you to be a better medic, and to bring your education and knowledge up to par with the other medical professions. Remember, working in the hospital, you become an ambassador for EMS. They will be watching you to see what you know and how you present yourself. And from your demeanour, they will decide what they think of the rest of us in EMS. You don't have to know everything to impress them. You just have to show them that you know what you do and do not know, and that you are eager to learn the rest. I don't recall ever working with an ER nurse who was not always eager to learn more. If you share that desire with them, then you will be respected and accepted as part of the team.

Oooh! I see potential in that combination! Although, I think I may know her. I have dated the only hott chick in Boston already.

Greetings, T. And welcome. Both of those questions have been cussed and discussed at length here, on an almost daily basis. They are hot topics. By now, you have probably searched around the board a little and found some topics and posts that have been helpful to you. But here is the general (meaning applicable to most, but not all situations) consensus: 1. When it comes to education, more is better. In fact, anything that takes place in 5 months is not even education. It is just training. Training is for firemen and monkeys. Education is for medical professionals. Which do you want to be? There is your decision in a nutshell. If you are concerned about the level of respect you are going to have, then the answer is clear. You need more education, not less. Think about it. Who are you going to respect more; some slug who spent five years as an EMT (ambulance driver with a first aid card) and then five months learning monkey skills, or somebody who went in with determination from day one to become the best medic they could be, and spent two years doing it? It's a no brainer. 2. The theory that more experience as a basic ultimately makes you a better paramedic is a fallacy. A myth. An urban legend perpetuated by those who don't have enough education and exposure to the educational process to know any better. Mathematically, it doesn't even make any sense. Check the numbers. Candidate A spends two years as an EMT, then two years in medic school. At that point, he is still a rookie medic. Candidate B goes directly from EMT school to two years of paramedic school. After graduation, you are a rookie medic. Now, two years later, you have two years of paramedic experience, just the same as the guy who drove an ambulance for two years before medic school. He didn't become a better medic than you, and he didn't do it any faster than you. There is a lot of idiocy in EMS, and in EMS management. Consequently, there are a lot of poorly educated administrators still operating on old, disproven, and outdated theories because "that's the way we've always done it." But we are in the midst of a major era of change in EMS too. The old ways have yielded us piss poor results for thirty years now, and the intelligent and progressive leaders in this field have recognised that if we do what we have always done, we will get what we have always gotten, which is shite. Therefore, you will see (in any employer that is worth working for) a rapidly changing atmosphere where EDUCATION is king. Where EDUCATION is what is looked at, not how long you worked as an EMT because you lacked the professional dedication to improve yourself. Where the amount and quality of your education is valued more than how fast you got it done. We are rapidly moving away from being a "technical job" that people are "trained" to perform, to a medical PROFESSION where lengthy and in-depth EDUCATION is expected from each of us. Those with nothing more than a five month tech-school certificate will be relegated to the bottom rung of that career ladder. In fact, in a growing number of states, they are being excluded from the profession altogether. That is the coming trend. It does not matter that the five-month wonder wears the same patch as the two-year professional. The patch does not make the man. We all know the difference between those two men, and it is significant. And anybody who believes that those extra hours of Anatomy and Physiology, Microbiology, Psychology, Sociology, Chemistry, Physics, Ethics, etc... do not make a difference in the quality of a paramedic is either fooling himself, or quite frankly an idiot. Or both. Good luck, Man. Today is the first day of the rest of your life. You are about to take the first step into the profession. Make it the right step. Dedicate yourself today, 110 percent, to being absolutely the very best medic you can be, not the fastest. And that means getting into a two-year (minimum) paramedic school ASAP, and remembering every single day that somebody's life depends upon how well you do.

Good deal! I trust you to make the very most of this opportunity. There is so much to be gained and learned in this environment. The possibilities are limited only by your determination. I've seen too many medics go to ER work for years and years, yet never break out of the "Me EMT. Me no need know all that." mindset. Just like they were in the field, they are worthless slugs who don't care about anything unless it involves "skills." But, I digress. Not only will you be exposed to a tremendous and continuous learning atmosphere, but you will have constant access to physicians, nurses, RTs and MTs, who are great sources of information to learn from. And you will notice that in the hospital, everybody is always in learning mode. The above professions recognise themselves as lifelong students, unlike most EMTs who come out of school convinced they know everything they will ever need to know. But again, I digress. Good luck, Bro! :thumbright:

See, I just find this whole claim incredible. I honestly cannot believe it ever has or ever would happen. We don't determine truck stock. And we don't determine the level that our truck is licensed to operate at. This whole situation has ZERO to do with us as medics. Nothing. Zip. Nada. Zilch. That would be like faulting a paratrooper for not jumping out of a plane when you failed to provide him a parachute. Think about it; if a truck breaks down, are the individual medics personally liable for not responding to the run? Of course not. They don't own the truck. They are not contracted to deploy the truck. And they are not mechanics. This is the very same situation. And I would very much like to see anybody come up with a link or reference to verifiable case law -- or even legal statute -- that validates this theory. Such a law would essentially mandate that we all carry a full compliment of ALS equipment and supplies on our persons 24/7. Not likely. I'm not saying it is impossible. I know the legal system is farked up. Especially up north. I'm just saying this is entirely improbable, and sounds more like an urban legend than anything else.

Don't hold back, Asys. Tell us how you really feel!

Yeah, what he said. It is just the nuances of this particular case presentation that make the technique undesirable. If space, manpower, and expertise allowed for a smoother transition, then there would not be a problem with going out the passenger door.

I wouldn't go that far. There are some strict NEXUS-ists here at The City who would dispute that. I, of course, am not one of them. But yes, this conversation IS about immobilisation. The concept of immobilisation encompasses everything you do to immobilise the patient's spine from first contact until you deliver them to the ER table. Immobilisation does not end when they are in the collar, in the KED, or on the board. Your means of extrication DOES matter. It is the continuation of the immobilisation process. That means you can't just package the patient, then jerk them about the vehicle during extrication without any regard to how much movement and stress is being placed on the patient. That is called "half-arsing" the job, which we have already established is wholly inappropriate. And until you understand this (even if you choose not to publicly admit it), you are missing an extremely serious point of patient care, and will continue to receive the distrust of those many educated and experienced medics here who remain perplexed that you just don't seem to get it. See! When you say things like this, I find myself saying, "Hey, he's not a complete idiot! That's a fairly intelligent thought which a lot of other intelligent people never even seem to realise!" I applaud you for that thought process. We are in total agreement on it. And it's not the first really impressive thing I have seen you say around here. That's why I am frankly stumped by your position on the immobilisation and extrication issue. You do seem sharp enough to know better. If she's hott (and doesn't have a wicked Boston accent), please give her my apologies and my e-mail address.

I'm intrigued by your use of the word "steal." If I were to take that money, whom would I be stealing from? Who is the owner of this money? The answer is (legally speaking), nobody owns the money. It is drug proceeds, and therefore will be forfeited to (aka stolen by) the government for their own illicit purposes. Again, whether I take it or not, there is zero chance that my patient is going to leave the hospital with it. The money belongs to nobody. Finders keepers. He who acts first wins.

Word. I have my price. If they want to pay me time and a half medic's pay to run a transfer truck, I don't have a serious problem with that. Somebody's gotta do it, and I could use the relaxation. It would certainly have the potential for some frustration if a serious patient presented, but hey... I have yet to work a day in EMS without frustration, so I can hang. I did it for many years on part-time, event stand-by gigs. I have some real doubts about the relevance of those lawsuits you supposedly heard about. There must have been some more factors that we don't know about. A provider cannot be held liable for an employers choice of equipment levels. That's just not even happening. Not to mention, I don't know many medics who have anything worth taking even if they were found liable. Can you get back to us with some details to clarify this?

Of course, that means that nothing has really changed with the introduction of NEXUS, since pretty much anybody who fails NEXUS is going to have MOI.

Tell that to your medical director, then get back to us from the unemployment line! Actually, Whit, you have a half-way valid point there. In fact, I have argued that very point here on several occasions. I have argued it with Dr. Bledsoe to the point that he wanted to physically hurt me. You are absolutely correct in the purpose of the NEXUS criteria. However, the reason that I and others find the NEXUS criteria of dubious value in the field is because it is not specific enough for field use. That means, there are some people who are cleared in the field by NEXUS who will still have SCI. That is both a medical and a legal pitfall of NEXUS. However, the same cannot be said about those who the criteria says should be immobilised. In other words, NEXUS is LESS restrictive than previously taught and accepted spinal protocols. Before NEXUS, EVERYBODY with a suspicious MOI got full spinal precautions. So if NEXUS says you get spinal precautions, then every other protocol would have also said so. Therefore, whining about NEXUS not being a field-applicable protocol doesn't get you any points here. NEXUS or no NEXUS, the patient in question is due full spinal precautions. I'm still perplexed as to why you believe it is an either-or proposition. Why are not BOTH of those factors to be considered? Are you incapable of balancing more than one decision at a time? Are you incapable of walking and chewing gum at the same time? I sure hope you don't ever have patients with both chest pain AND shortness of breath! What are you going to do then, give them Nitro and ignore the dyspnea because two factors are too overwhelming for you? Seriously dude, I once thought you were a relatively smart guy, but you're just digging yourself very deeply into a bottomless pit of incredibility. Please point me to any quote on this forum where I even came close to making any such claim. Obviously, your powers of character judgement are as inadequate as your medical judgement.