Dustdevil

The very MINIMUM education you should have to enter EMS is two years. So, that gives you two years to clean up your driving record before you're ready to hit the street. If you're serious about this profession, you shouldn't have a problem with either of those. If you do, you don't belong here. Good luck!

I don't really see that as an advice to "drop out." It was more along the lines of advising him (and rightfully so) to go a different route to the same destination. It's damn good advice, and I would advise ALL newcomers to take it. It will benefit not only those who do it, but the profession as a whole.

Good for you! That's a good sign. But it's not the emotion I was referring to. It is the act of asking people to spoon feed you answers that are easily available on the website and from your course coordinator. It's like the people who come here asking questions that are already answered in twenty previous topics because they were too lazy to use the search button. It's annoying. Just trying to help you save some dignity with NREMT by allowing you to learn from others' mistakes. I would be very shocked if you were the only one in the class who failed. That means you have classmates in the same boat. Get with them. Study with them. Get your answers from your coordinator with them. Don't be a lone wolf. Help each other out. Each of you bombed different things. Sharing your experiences with each other will be beneficial to you. And, as PRPG astutely stated, do NOT overthink the answers! Go with your gut instinct on the questions and move on. Don't go back. It's really this simple... 1. Search the NREMT site for upcoming test dates and sites. If there are none that are even remotely convenient for you, call them and ask them for others (some aren't listed on the site). 2. Call the testing site and register for the test. 3. Study your arse off until the moment you leave the house for the test. 4. Retake the test. 5. Go be a fireman, since that's all you really want to be anyhow, and forget everything you just learned. Any questions? Look on NREMT.org. Good luck!

Warning... if you go off half-cocked, writing letters without first looking for the answers on the NREMT website, and consulting with your course coordinator/instructor, you're going to look like a huge, annoying tool to those who have to read it and tell you to go read the website. Sit down. Take a deep breath. Do more studying on this issue than you did for your class. And get everything straight before you go back to NR. There's the problem right there. You're trying to learn medicine from a fireman.

Interesting! Who is running it? We can't hardly even get CLS classes going here in III Corps. Somebody always shoots it down. Military nurses (as well as all professional positions) are all civilian trained and licensed, so transferability isn't really an issue like it is with the technical trades.

Generally speaking, yes.

Can you be more specific about what you are talking about?? If you mean combat first aid training, no, it does not give you credit towards EMT school.

Unfortunately, you are correct. It is not something that is typically taught in US paramedic school. In fact, pulmonology is seriously glossed over for the most part. Most come out with a pretty weak understanding of ABGs, at best. And their understanding of oxygen therapy is geared more towards recognising an oxygen bottle than towards actually recognising their patient's needs. Very sad. But the better students recognise this and compensate through independent study.

For what it's worth, I completely agree with yours.

Are you talking about auscultated wheezes, or audible "wheezes?"

Ah, okay. Then technically, you aren't actually providing "PPV @ 15lpm." You are providing PPV at a totally unknown rate/volume with 15lpm of oxygen flowing into the bag or reservoir. And depending upon the BVM model, it may require less or more than 15lpm to achieve. In other words, yes, your patient needs PPV. And he needs maximum FiO2. But how much oxygen flow he needs is not chiseled in stone. To mention the oxygen flow in your statement is like specifying a syringe size in a medication order. It's not really relevant.

That is what I concluded. His chief complaint was diarrhoea, nausea and vomiting x 24 hours. Viral gastroenteritis with dehydration was my diagnosis. I think the sudden F&E shift just kicked his kidneys into overdrive dumping sugar temporarily. Was certainly a weird finding though! I had to consider there for a bit that AODM may have been the condition behind the symptoms. Turns out though, that it was just a sign of the dehydration. I put two litres of fluid into him and he looked and felt fine the next day.

And even if you don't need to treat it, you don't look like a tool when the ER puts them on the monitor and finds something that easy that you did not find. Reminds me of some of the medics here. Somebody comes in with diarrhoea, and they just hand them Imodium and a lecture about liquid diets instead of doing a proper exam and finding out that an ear infection was the reason for the diarrhoea in the first place. Treat your patient, not his symptoms. Without assessment, we are nothing.

By what delivery method? Where do you get that figure?

Maybe I ought to see an optometrist too, because everytime Asys posts, I see double or triple. :? You really need to get that looked at, dude! But yeah, that same attitude is responsible for as many wrecks as it is responsible for road rage. All those people who drive legally, but aggressively, with the mindset that "I have the right of way! If we wreck, it's HIS fault!" instead of just driving defensively and avoiding the situation altogether. Who the hell cares whose "fault" it is. Your car is still smashed! Just avoid it!

Ah... I apologise for the misunderstanding. I was going by the earlier post which said your protocols read to "consider" air evac for significant MOI, not to automatically fly everybody with significant MOI. If your protocols were misquoted, then I stand corrected. But if not, then yes... those who substitute the words "must fly" for what the protocols actually say are protocol monkeys. Those who use ambiguous protocols as an excuse to operate like a robot instead of actually evaluating their patient. I certainly agree with you that the best medics I find are those who exist somewhere in the happy medium between protocol monkey and rogue. Like life itself, medicine is about balance.

I had a patient yesterday with a urine glucose of >250, yet his blood glucose was only 113, and he had no diabetic history. That one threw me for a loop!

This is why a year of English should be required for paramedic licensure. Read your protocols more carefully and you will find that you are not being told that you "must" fly everybody for whom you imagine an "MOI." When I hear this, I always wonder if these people really misunderstand their protocols that badly, or if they are simply utilising them as an excuse to call out helicopters as often as possible. Either way, it makes medics look really bad.

If you can't tell from looking at the patient that he has one of those critical problems, he can go by ground. And if he had one of those problems and you didn't pick up the signs, you need more education and practise. Flying somebody just because the car is crumpled is simply retarded. Anybody with real experience figured that out a long time ago without having to be told by Dr. Bledsoe et. al. that it's outdated and pointless.

WTF? That "criteria" is fine if you are flying out the ambulance itself. But we're talking about people, not ambulances. MOI is irrelevant, and those who are still making these decisions based upon such neanderthal criteria define the term "protocol monkey."

Oooooooooh! How did I miss this topic before? Plus five for an excellent topic, and for the excellent replies! This should be the number one point stressed in paramedic school. EMT school too, for that matter.

You're kidding, right? You can't be serious. Use your head. You're in CALIFORNIA! The birthplace of fire-based EMS! The only place that the local politicians are going to "jump" is to their fire chief. Then you won't have to worry about your "low paying job." In fact, you will have no job to worry about at all. And you will have only yourself to blame.

As a provider, I treat the patient, not the monitor. That's the first thing the competent among us learned, and we practise by it. The problem here is that you haven't been treating anybody or anything. You've just spent a lot of time staring at 3 lead monitor screens and thinking you understood the squiggly lines. There is a big gap between theoretical and reality that you have yet to grasp. Back to school with you. BTW, I notice that in your zeal to tell everybody how wrong they are, you still haven't told us what the rhythm is. Interesting. And wtf said anything about lidocaine? :roll:

Well... first you should realise that ALL EMT-B classes are seriously inadequate. Some are just more inadequate than others. That said, how much calendar time a class takes up is usually irrelevant, and not necessarily indicative of how good it is, or how much you will learn. For example, I studied German for two years in high school and didn't learn dick. I studied Spanish for one month with some audiotapes and learned to speak and understand quite well. Quite obviously, calendar length is not a primary indicator of educational quality. Lots of complete functional illiterates come out of semester-long EMT schools. Lots of sharp cookies come out of one-month schools. There is really no difference between the two, generally speaking. The amount of educational contact time you spend is the very same. One is dragged out. The other is packed in. It really all depends upon you. Learning is a very individual thing. Most people need study time between classes to really commit facts and concepts to memory. Some don't. Some people actually learn less in extended classes because they are too easily distracted to study in-between classes and end up forgetting more. What works for me may not work for you. You will have to think back on your educational experiences and honestly evaluate your learning style. Do you need study time to let things sink into your head and get them clear? Do you absorb things clearly, rapid fire, and retain them exceptionally well without having to review them a lot during the process? Do you have to work during the time you are attending school? If so, forget the one-month class. I don't care how smart you are, your plate needs to be completely clear during this rapid fire immersion process if you have any serious hopes of actually getting a quality education. Whatever you do, best of luck!

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