Dustdevil

Good question! Working out before work indeed becomes a challenge. You figure you have to wake up 1½ to 2 hours before work on a normal day. If you are going to work out, that becomes 4 hours before shift that you have to wake up. Factor in getting off work late, travelling home, running errands, and the rest of real life and that means less than 6 to 8 hours sleep, which can do you more harm than the workout does good. It's a Catch 22. Plus, who wants to go to bed all sweaty? All that said, I do agree that it is much easier to motivate a pre-shift workout than a post-shift workout. And, as you probably know, once you are into the routine, it is actually pretty easy to git 'er done. It becomes habit, just like brushing your teeth or buckling your seatbelt. But if you try to do it post-shift, it becomes really easy to say "aw man, that was a bad shift" or "I have too much to do today" and blow it off. For that reason, I prefer the pre-shift workouts. That way, you always do it at the same time each day, stabilising your routine, whereas with post-shift workouts, it is going to vary with the time you get off. Of course, you're kinda screwed in Ontario where they work those idiotic, asinine, irregularly rotating shifts that nobody else in the world works, and that should be illegal. Consequently, you are going to face greater challenges in maintaining a routine than somebody with a regular schedule. I just hope you belong to a 24 hour gym. :? Ideally, your employer or the police or fire departments would provide you with a workout facility that you can access at any time of day or night so you can hit it immediately after work without having to travel across town. Alternatively, if you are well experienced and disciplined in exercise science, then the home gym is a viable alternative. It should be noted that over ninety percent of all home exercise equipment never sees a drop of sweat and just collects dust in a corner of the garage. That means that nine times out of ten, it is a total waste of money because people cannot motivate themselves (always thinking, "I'll do it later."), and/or don't have the knowledge to utilise it with any degree of competence. But, if you are the exception to the rule, it really doesn't take much to get in a great workout at home. Run, with or without a treadmill or StairMaster. Press a barbell. Lift and curl a small collection of dumbbells. Pushups, pullups and crunches. Stretches. Unless you are a competition level bodybuilder, there is nothing wrong with a home workout, if you stay disciplined and work smart. That brings us to the two most important factors to any workout program; discipline and knowledge. Consult a trainer, or at least do some extensive reading research on exercise physiology so that you are doing the right exercises, the right way, in right sequence, the right amount of time. That assures that you actually achieve some results, which is of paramount importance in maintaining your discipline and motivation. Without that, your program will fail, whether at the gym or at home.

Of course, their counter argument will be that they have been trained on said drugs. :roll: Trying to explain the difference between training and education to these people is futile. And if they can't understand that simple concept, it's hard to figure why anybody thinks they can understand complex pharmacological concepts. By the way, I don't know about everywhere else, but the police academy is as long as paramedic school here. Time on the firing range alone is almost as long as most EMT courses. And EMT's wonder why they get no trust or respect.

I think I'd use it as more evidence to take to my community leaders and demand that they provide a reasonable standard of care for the taxpayers. If they are failing to provide full-time professional ALS care to the community, both they and the citizens need to know it and address it. That's the best thing you could do for your patients.

I think that is probably giving them way too much credit. Chances are, they probably don't have 200 hours total, including clinicals. Most probably are vollies who don't even have 200 hours, including didactic, clinicals, and time on ambulance runs. Including non-emergency transfers.

I don't think anybody is upset, except maybe for Ace. I'm just still a little perplexed as to what your question was. The subject line leads us to believe we are talking about the study. The poll, it seems, only asks if we have ever heard of Polyheme itself. But then you ask us to "chime in" as if the poll question is supposed to stimulate great discussion. So, that leads me to believe you are looking for something else. Nothing wrong with the topic. I just think people quickly tire of answering the same question over and over. Ever taken a long road trip with kids in the car? How many times do they have to ask you, "how much longer before we get there?" before you're ready to slap them? That's why you have gotten the above response. As exhibited by the response to previous threads of the same topic, there is indeed big interest in it. While I doubt that most medics have done any serious research into the yet-to-be finalised study (I sure haven't), I do doubt that very many have not heard of it at all. And, as I stated, I really am not terribly impressed by somebody spending a lot of time reading about things that aren't even available yet when chances are they still don't know enough about those drugs and therapies that are already in their box to call themselves a professional. Getting ahead of yourself just isn't that impressive to me.

Uhhh... so what's new? The same thing applies to every other medical profession, including doctors and nurses. We are a nation of independently governed states. That's how it works. Add US Government to the list of classes that should be mandatory for paramedic school.

What exactly are you talking about? Yes, I know what Polyheme is and all that. What I don't understand is what your point is. What makes you believe that most have not heard of it? Or are you asking if they have heard something specific about the study results? I'm not criticising your question. I'm just trying to clarify what exactly your question is. I think most medics know little enough about the therapies that they are currently using that it is unreasonable to expect that they spend a significant amount of time and effort pondering "the next big thing." I'd be more impressed if they simply spent time improving their understanding of that which they already use.

There is an entire forum for this topic: EMS Off The Road Amusement parks, camps, industrial clinics and response, doctors' offices, hospitals, military. There are people on this board in all of those jobs. It's not uncommon.

That's if the dispatcher isn't too busy running driver licence checks for 20 cops and feeding prisoners.

Significantly longer than it takes to exsanguinate. Longer than it takes to go from sinus tach to asystole. Aren't you glad you don't live there? And if you did live there, don't you think you would have been in your community leaders' faces about it by now?

I didn't say they were bad medics. I am referring strictly to the quality and autonomy of their practice. I am not passing judgement on their knowledge, intelligence, or competence. They may be the smartest medics in the country. They simply aren't allowed to practise it. It is a judgement of the system, not the people. Why is it that so many people take comments about their employer so personal? :?

Most US paramedic programs don't have a specific course dedicated to any topic at all, much less pharmacology. Most US paramedic programs are not a serious of courses. They are just one long course with every topic mixed in like a salad. In those courses, pharmacology is around two to four weeks of the 10 month program. And that time is more focused upon teaching you only those concepts related to a specific list of drugs instead of a broad educational foundation in pharmacology in general. Many of the two-year programs really aren't much better.

So, lemme get this straight. You've gone from college and the corporate world to your very first ever EMS job and suddenly you're qualified to tell us that one place is better than everybody else? :roll: A -- there aren't many systems like that anymore, so that doesn't make you better than very many. B -- It sucks arse compared to systems where they trust their people to practice medicine instead of memorise a book. Being a medic in a system like EMSA is like painting by the numbers and calling yourself an artist. Being a medic in a system like EMSA is like a fryer at McDonalds calling himself a chef. Is it a good system? Sure. Has lots going for it. But like almost every heavily bureaucratic metropolitan service, it has at least as many negatives as positives. Restrictive practise. Politics. SSM. High volume of non-emergency transfers. Puhleeeze... get out of your little cubicle a little before you start trying to tell us how you compare to the rest of the world.

WTF is an EMT-J? An Orthodox Jew? :?

Sorry. My position is that I feel safe with them knowing the "B" level in practise IF they were at least educated and comfortable with "C" level understanding when they graduated. In other words, I don't think it is unacceptably risky to expect that "C" level understanding will eventually digress to "B" level in practise. I am not at all comfortable with the "A" level of understanding in the field, or in education. And I'm not exactly happy with the "B" level either. But I am comfortable with the "B" level being the rock bottom level of understanding for the practising field provider. And again, I must emphasise that educational programs and incentives must constantly work to improve that level so that the providers knowledge does not degenerate. Sorry... I am having a hard time explaining this for some reason. :?

By the way, when I came home from my first stint in the military in 1978, that funeral home was still running EMS for the city. Still running three units, with all of them being high top vans (type III) purchased within the last two years. Everybody was at least an ECA with about half of them being EMT's. By then, a couple true ambulance services, not associated with funeral homes, had sprung up in the Dallas area and were moving towards taking over EMS from the funeral homes. They did so in my hometown in 1976, the same year the first paramedic class in the county graduated, but did not provide ALS until 1986. Dallas Fire Department took over EMS for the City of Dallas around 72 or 73, but didn't provide ALS until 1975. And around 1977 is when funeral homes started getting out of the business around the rest of the area. My old funeral home gave it up to a short-lived hospital-based service out of Dallas about 1980 or 81. The City of Fort Worth continued to be run by the long time funeral home provider up until about 1983 when a private company was contracted. I don't think I have seen a funeral home run ambulance service since then.

I am curious if any of you have actually encountered a situation where these shears were actually the answer to a problem that could not have solved by standard $3.50 trauma shears. I'm sure such situations occasionally arise, but it's awful damn rare. Can you describe some for us?

I agree that the "B" level is what is taught in most paramedic schools, and it is probably the minimally adequate level of understanding for the practising professional. But remember, nobody remembers everything from school. Your knowledge decreases after graduation and continues to do so unless you are very conscientious about your continuing education. Therefore, I believe that the "C" level is what should be taught in initial education. It is indeed important that you understand pharmacology in much greater detail before beginning to practise it. Maintaining that depth of understanding isn't quite as important, simply because it is that greater understanding that prepares you to practise comfortably and intelligently. If you forget some of your cellular physiology after a year or three of practise, that is understandable, and as much as I hate to say it, probably even acceptable to a great extent. However, it is unfortunately too easy to sink to this lowest level of acceptability and stay there. Then you begin to take things for granted and start practising at level "A", and don't bother to learn your new drugs in depth when they come out. You have to figure that a great many medics will regress at least one level soon after beginning practise. If you teach them at the "C" level, then you can count on keeping most of your people at the "B" level of understanding. But when you start at the "B" level, then you can count on most of your people eventually practising with "A" level understanding at best. We have a term for those medics here in the U.S. Firemen. I'd be comfortable allowing a medic with "B" level understanding to practise in my system. But I would strongly encourage and even mandate that all my personnel continuously improve their understanding. And those who didn't would find themselves unemployed. I would not allow anybody to graduate from my school with less than "A" level understanding.

The significance of this point should not be overlooked. Too often I hear people inaccurately talking about how EMS was a conflict of interest and all about the money for funeral homes. That's a crock of crap. We as funeral homes began running the ambulance services not as a business venture, but simply because our communities requested it of us, as we were the only ones with vehicles suitable for the purpose. There was no money made. It was simply a way to provide a valuable service to the community and establish goodwill and a positive image among the citizens. The best we could hope for was that somewhere down the line, they would remember that service and choose us for their funeral needs. We certainly weren't guaranteed that business. In 1973, I was paid ten dollars a day to stay at the funeral home. When not making ambulance runs -- which were much more rare back then -- we answered the phones, greeted visitors, carried flowers, cleaned and vacuumed the offices, moved caskets around, and basically assisted in normal business. When we made an ambulance run at night, I think we got an extra ten dollars. We charged about $30 dollars for transportation, so IF they collected on that bill, they really made no money after paying two attendants and costs. And of course, like today, many simply didn't pay. For the most part, funeral homes were not pushed out of EMS, as is popularly theorised. They jumped at the first opportunity, as soon as somebody else filled the need! All that was required to work on an ambulance in 1973 was a Red Cross Standard First Aid card. To drive, you also had to be at least eighteen years old and have a driver licence. I was only sixteen, but I already had an Advanced First Aid card. I was one of the highest trained guys in the company. They were just beginning to train Paramedics for the fire department in Dallas, but nowhere else. There were a couple EMT schools just opening up, as well as 40 hour courses called "Emergency Care Attendant," or ECA. I got into the ECA course soon after starting to work and became the first ECA in the company at age sixteen. There were two other high schoolers working there. The rest of the guys were probably between 18 and 22, except for the funeral directors, who pretty much left all the ambo work to us kids. I have to say, that list of supplies that Robert posted is a LOT more extensive than what we carried in 1973! We had a total hodgepodge of assorted first aid supplies that was not consistent in between the units. What any unit had on it was very dependent upon what we could beg, borrow, or steal from the ER. The best ambo -- the new one that all the senior guys used -- had a nice salesman's sample case full of bandages, glass bottles of saline, a stethoscope and sphygmo, and not much more. The others either had a Samsonite briefcase or a Craftsman toolbox for our med kit. Most of the time, we never even took the kits out of the ambo unless we knew it was an injury. Even then, it was rarely used, much like the so-called "trauma kits" today. We had three ambulances. Top of the line was unit 83, a brand new Chevy Suburban that had been customised by a "professional car" builder in Dallas. Solid white with no markings other than the name of the funeral home painted in black script across the side and a nice new Federal TwinSonic light bar on the roof. I think it was the first ambo we had with an electronic siren. Next was unit 82, an older GMC Suburban that they had built the cabinets and cot-rack for themselves. It had three Federal Beacon Ray's on the roof, the kind that had four bulbs, including two that point up and down, and they oscillated back and forth instead of rotating. It had a Q2 siren in the middle. Finally, unit 81 was a combination car like Robert described. A 1970 Pontiac high top hearse, painted blue with a black vinyl roof. No markings except for the metal signs in the back windows with the name of the funeral home and the numbers "81" stuck on each side of the single Federal Beacon Ray mounted on the roof. It had a Q1 under the hood along with a couple of red flashers behind the grille. We used single channel Motorola low-band VHF radios with our own channel in the 45 mhz range. We constantly got radio skip from hospitals, veterinarians, and other funeral homes all over the country. And now, back to the most significant point about the above statement. The fire service does a lot of revisionist mouthing off about their altruistic vitrue and long mission of protecting life leading them into EMS. It's crap. Once you have the historical perspective, you quickly realise that the fire service ended up in EMS for very much the same reasons that the funeral service did. Community leaders stuck the fire service with EMS for one reason, and one reason only. They figured they were already paying those guys to sit around on their arses all day anyhow, so why not make them run the ambos and earn their money? Just like the funeral service, the fire service ended up in EMS simply by default, not because they were best suited to do so.

Thanks, Fan! :thumbright: Meh... gloves are just an excuse for lazy providers to not wash their hands. Conscientious hygiene is key, not rubber.

Set your MS Word language to UK or Canadian English for even better results.

Start hiding your assets today, bro. :?

Why? Sounds like some power-hungry bureaucrats are trying to justify their inflated salaraies.

And I suspect that most of you draw blood simply because it's "allowed," and not because it is actually needed. The question was, do your receiving hospitals actually use the blood, not do you draw it.