Dustdevil

Depending upon where you live, you will probably have no choice. Most communities have only one EMS provider. It may be a city agency. It may be a county agency. It may be a hospital. It may be a fire department. It may be a police department. It may be a private company. It may be a non-profit organisation. Whatever it is, that is what you are stuck with, take it or leave it. If you don't want to work for something different, you're going to have to either travel or move. There are pros and cons to all of the above types of systems. And there are pros and cons to both the city and the country too. Here, working out in the country does not necessarily mean you aren't busy or that you don't get a chance to keep your skills sharp. It usually means the opposite, so don't fall into the trap of believing that a big city will always you better experience. It usually doesn't. Your wife's nursing licence is definitely the ticket in. No problem. And she can get a job just about anywhere. You, on the other hand, cannot get a job just anywhere because you may or may not be qualified in all states, and because you probably won't be looking for a job in a fire department, which dominates many of the major metropolitan cities. Tell us where you are looking at and maybe some of us can help you find out about the area.

Correct. You have a problem with that? What are you, a Communist?

Exactly. Brought to you by the same people who brought you rotating shifts that take you from days to nights with no rest and are designed solely to burn you out before you can retire. And uniforms that make you look like a cop. Tis bullshit. Because something is the "prevailing attitude" and "way we've always done it" does not in any way qualify it as good. The truth is, all the vets just want you to "pay your dues" as an ambulance driver because they don't want anybody getting there faster than they did. And the schools require experience not because it makes you a better student, but simply as a way of thinning the heard of applicants and assuring that those already trying to make a living in the profession get the earliest chance to upgrade. Nothing wrong with that. But simply put, it's just bureaucracy. It's not of any benefit to you. If you can get in, get in. Do it now.

http://www.airforce.com http://www.goarmy.com Look no farther.

I agree with you for the most part. Those people who make it their personal mission to harass patients to determine if they're faking just as a matter of personal pride are dangerous and should be fired. In the long run, it really doesn't matter whether they are faking or not, you still have to transport them. So why not just get it over with? On the other hand, if somebody is obviously faking and you write up a PCR reflecting a serious situation, you're going to look like a total knob to your medical director or QC manager, so you had better stay alert and at least document any inconsistencies you discover on exam.

Well then your union sucks! I'd fire them and get somebody who could accomplish something positive.

I prepare by avoiding the situation altogether. I wouldn't work anyplace that used rotating shifts. They aren't interested in employee welfare, so I am not interested in them. Good luck!

Completely disagree. There is absolutely no support for that claim. No other medical professional makes you practise at a BLS level before admitting you to the ALS portion. Nurses, physicians, PA's and respiratory therapists practise ALS from day 1. Either you're smart enough, or you aren't. A few years of BLS practice will not make you any smarter. Your ability to bandage, splint, and drive an ambulance will simply contribute nothing to your ability to grasp advanced education. Go for it. ASAP.

Never heard of such a practice, even when working hospital-based systems. :? I don't think many medics know when it is or is not appropriate to gown a patient, and to what extent. And you don't know where they are going to be waiting for the next several hours either. Don't forget, everything you remove from your patient during transport, you are responsible for. This will just increase the frequency with which patients personal belongings are left on your ambulance. And, of course, can you really justify asking somebody to disrobe for the hospital? I know that if I as a patient asked you why you wanted me to disrobe, and your best answer was, "because the hospital might want you to," I'd tell you to feck off and die. And report you. I see nothing good about this idea.

Your point is lost. Perhaps you aren't familiar with the terminology though. An ACP is an ALS paramedic. And, as was well explained, it takes an advanced provider longer because he's doing more than taking a pulse, respirations, and blood pressure before transporting. When you have nothing to offer the patient, then yes, you need to get off the scene. But an ACP will in many cases be providing on-scene treatment to the patient instead of making him wait through a ride to the hospital before receiving any care. After all, that is what we are there for. If that takes half an hour, so be it. It still beats waiting until they're seen by a busy ER doctor.

Actually, that is not what I was saying. I was merely commenting on the frequency of reported ailments among females as compared to males. I made no comment regarding how well they take it. Little boys tend to frequently wear a bloody knee all day long as a badge of honour. Little girls want it washed off and covered up ASAP. I'm not saying they cry any more about it than boys. I'm just saying that they tend to get things taken care of more often than the boys who are too ADD to stop playing and see the nurse. By the way, I'm going to be très pissed if WholeHam doesn't bother to come back and read this topic! :x

Reasonable guess. I postulated the same. BGL should be much like O[sub:9146167cba]2[/sub:9146167cba], in that the farther along in the circulation you go, the more glucose (or oxygen) will have been extracted from the blood.

I knew this was going to start happening as soon as that rapper started calling himself Ludacris. The word is ludicrous. A lot of today's medics would do well to pay more attention to education and less to pop culture. Anyhow, I believe you are discussing a different point than most of us. I have no animosity towards new grads whose skills or knowledge are inadequate. I fully recognise that their education was $hit, and that their lame arse school let them get by with the mistaken believe that they knew "enough." That is not completely the student's fault. But it IS their problem. And my patience with them is dependant upon their attitude. If when I try to teach them something they are attentive and receptive, I will give a full and totally patient effort to developing them into a good medic. I think we all would. But if I have to constantly go drag their arse out from in front of the boob tube in order to get anything accomplished, or if their reply to every bit of advice is, "Oh, I already knew that" or "Meh, I don't really need to know that" or "That's not how we do it at the VFD" or "Dude, I can't wait til we get a good wreck!" then yes, your time with me is going to be very stressful, and you're likely to not pass the test. It's all about attitude, not competency. I honestly don't give a rat's arse how good your so-called "skills" are or how well you did on NR. You had best be ready to be a rookie. That means keeping your eyes and ears open and using your mouth for constructive purposes. It means immersing yourself not just into the job, but into the profession. It means accepting that your education has really just begun, and that it's not time to relax and just vegetate until the next trauma comes in. If your attitude is good, your time with me as a partner will be both enjoyable and educational, regardless of your "skills."

Hey Rid, how long you figure before we come full circle back to IC cardiac drugs again? It's bound to happen.

Not by anybody who matters. :wink: The force is strong in this one, Jake!

You can see the embroidery needle tracks on the white background. Apparently, the machine operator caught the machine being out of red thread after the first two letters, stopped the machine and refilled it, then re-started it and forgot to pull out that patch. I doubt there are hundreds of them floating around like that or anything, lol. Definitely a keepsake! I actually have a patch from an old employer in the 80's that is like that. You can tell the machine ran out of thread on the top of the patch, then got refilled before it got to the bottom.

Actually, I hear they do in Quebec. 8)

Like this?

You have to evaluate an education based upon content, quality, and contact hours. How many weeks or months or years it takes to complete the course is irrelevant. I can make an EMT class last anywhere from two weeks to two years by reducing the number of hours per class and per week accordingly. It's meaningless. You're still only getting 110 to 250 hours of instruction, maximum. Do you really think they can teach you anything impressive in that short time? The guy who cuts your hair has about twenty-times that education before he can take his test. Think about it. Before you spend a dime on an EMT course, you had better do some very serious and focused job market research in the area you intend to work. That doesn't mean looking in the want ads. That means getting on the phone and calling every service listed in the phone book. It means putting on some slacks, a shirt and tie (or dress, as the case may be), and going to visit them and asking them what your job prospects are as a brand new graduate EMT. Ask THEM if you can even get a job. Ask THEM what they pay. Ask their employees what they make and what their working conditions are like. What you are likely to find out is that the only job you are going to find in urban Mass is not an EMS job, but an ambulance driver job for a private, non-emergency transfer company, hauling grandma from the nursing home to her doctor's office and back all day long. And for damn little money. If you are happy with $8 to $12 dollars an hour in urban Mass, then I hope you are comfortable living with your parents for the foreseeable future. Sure, a paramedic makes a couple dollars an hour more, but those jobs are just as hard to come by. You won't find a real EMS job in the Boston area until you have several years of experience. Things are not as they seem. PLEASE do the research and the math before you commit to this nonsense. Don't leap before you look.

Oh man, where to start! :? First thing, hopefully you have either some military medic or ER tech experience behind you. No offence intended, but be aware that if EMT is your only medical training or experience, you probably don't know two percent of what you need to know to be a competent camp medic. You will probably get through a whole summer without seeing a single thing that was covered in EMT school. No fractures. No diabetics. No CPR's. No CVA's or MI's. Just a lot of minor cuts and scrapes, splinters, insect bites and stings, sunburns, poison ivy, ankle sprains, ear infections, sore throats, allergic rhinitis, tummy aches, headaches, nausea and vomiting, malaise, and homesickness. A good pædiatric practice handbook like "Current Pediatric Diagnosis and Treatment" would be helpful, but only if you are well schooled in anatomy and physiology and medical terminology (well beyond the EMT level). If not, you're better off with a family medical guide written for lay persons. Another book that would be extremely helpful would be a pædiatric phone triage handbook for nurses. Read it thoroughly. It will be your best resource for deciding what needs to go to the doctor and what can be treated in your clinic with supportive care. Quite invaluable. If you can find a good handbook on dermatology for recognising different rashes, that is good too. If you mistake chicken pox for mosquito bites, or an medication reaction rash with a detergent rash, it can be serious. Impetigo and a fungal rash are very similar in appearance, but are treated very, very differently. One requires a trip to the MD. The other does not. You need to know the difference. Learn to do a thorough, physician style (not EMT style) physical examination and history taking. Of course, if you'll have Internet access on-site, take advantage of it and study up on all this stuff constantly. You'll want to read up on all of the above conditions and know them thoroughly, because you will see every one of them. Treating minor cuts and scrapes and burns sounds simple enough, but surprisingly few EMT's or medics have any experience with it other than what their mother did to them, which was usually wrong. Knowing the difference between allergies and strep throat, a lac that needs sutures and one that dose not, otitis media and otitis externa, a sprained ankle and a broke ankle, a tummy ache from appendicitis, a sinus headache from dehydration, and a faker from a really sick kid are skills that can only be acquired through education and experience you didn't get in EMT school. You'll need to know who you need to watch overnight and who can go back to their cabin or tent, as well as what to watch for and how often. You'll also need to know who needs to be isolated for contagion and who does not. If you are at a boys camp, you're lucky. They hardly even go to the clinic for the minor stuff. They suck it up and usually take care of their own. If you are at a co-ed camp, be prepared for ninety-percent of your patients to be females. Even at an all boys camp you'll typically have a high percentage of female patients because of the female employees and family members. If you are at a girls camp, God have mercy on your soul. You better become an expert on menstruation and "the talk" before you get there. You're going to need it a few times when a ten year old gets a surprise visit from Aunt Flow. Brush up on your patient mom skills. You're going to be constantly busy. Before the kids arrive, you will want to meet with your medical director and get absolutely straight what your parameters are. Some will want you to send everything that complains to their office. Others will want you to make clinical judgements and decide who needs to see them and who doesn't. If you aren't up to those kinds of decisions, be honest with him or her! Don't try and fake it and act like you know more than you really do. Some kid will end up suffering for it. It is way too easy for a remote EMT or medic to get cocky and start playing doctor without the real knowledge necessary to do so. Resist that temptation. If you're not sure what is wrong with a kid, call the MD and get an opinion. That's what they're there for. Supplies? You won't need much of the stuff you find in a "trauma bag." You might use a couple of rolls of Kling or a Surgipad or two over the summer. Possibly a handful of triangular bandages if you get a forearm or collarbone injury. There's a good chance you won't need any of it at all, but you'll still want to have it handy just in case a kid falls off a cliff or into catches himself on fire. Kids can indeed get pretty badly hurt out there. Mostly you'll need lots of Bandaids (cloth, not plastic) of every conceivable shape and size. Don't forget the extra large ones for big knee scrapes. Tincture of Benzoin for making the Bandaids stick better in the sweaty summer. Two and three inch Telfa pads for bigger wounds. Bulk 4x4's for scrubbing wounds. Tape (you can get by with just Transpore plastic tape, but elasticised cloth tape is handy for bigger dressings too). Antiseptic spray or solution for cuts and scrapes (Forget about hydrogen peroxide. That went out in the 1980's). NeoSporin ointment (preferably in the little single-use packets, not tubes). NuSkin liquid bandage. Sterile saline irrigation. Eye wash solution (small individual bottles. Don't share between patients.) Visine drops (too long in the sun, dust, and water is hard on kids eyes). Betadine solution. Cotton tipped applicators. Super and Junior tampons. Maxi Pads. Americaine anaesthetic spray for burns and scrapes. Aloe gel with Lidocaine for burns (keep it refrigerated for better effect). After Bite sting swabs or sticks. Lotrimin anti-fungal cream. Anti-fungal foot spray. Anti-fungal foot powder. Hydrocortisone cream. Caladryl lotion. Blistex lip balm. OraJel oral anaesthetic. Swim-Ear drops. Instant ice packs, as well as some re-freezable gel packs. Two and three inch ACE bandages. Some really, really good splinter forceps. Some sewing or hypodermic needles for helping to remove splinters and popping blisters. Some moleskin and blister pads. Assorted splinting material, especially a couple of malleable SAM splints if you can get them. Oral and rectal thermometers with sanitary covers (if they have an ear thermometer, throw it away. They're $hit.). Surface disinfectant for cleaning equipment and exam tables, etc... Some bottles of refrigerated Gatorade for rehydration of heat emergencies and diarrhea kids. Some Sprite or 7up (not refrigerated) for kids with nausea and vomiting to sip on. I can guarantee you that you'll utilise everything on that list over the course of a summer. As for meds, don't go stocking up on anything until you talk to your MD. No Tylenol. No nothing. Tell him what you are comfortable dispensing and go from there. Remember, your EMT cert didn't cover that thing, so you are sticking your neck out by handing out even OTC meds. The standard OTC fare I recommend -- so long as you are INTIMATELY familiar with their uses and pædiatric dosages -- is Tylenol, Advil, Aleve (especially for menstrual cramps and sprains), Alka Seltzer, Mylanta, Imodium AD, Tums, Benadryl, Sudafed, Claritin, NyQuil, Cepacol lozenges, Robitussin cough drops, and Halls Mentho-Lyptus drops. As for the first three, the MD's office nurse can probably fix you up with a big box of each for free from her sample closet. And individually wrapped meds (including ointments, etc…) are a MUCH better choice than shared bottles. Try to get them if you end up shopping for yourself. If you're lucky, the MD might go for a couple Epi-pens. If you're in fire ant or mosquito country, he might send you some Rx steroid cream sample tubes to keep on hand. They work much better on hardy insect stings than OTC Cortaid. Possibly a tube or jar of Silvadene cream for burns (keep it refrigerated and it makes burns feel MUCH better). And if URI's get so rampant that the clinic starts filling up, he might call in a big bottle of codeine cough syrup for you to help the kids in the clinic get a quiet night's sleep. Don't go asking for any of those until you need them though, and again, only if you are intimately familiar with their use. Don't forget to wash your hands thoroughly before and after every kid you see. Otherwise, you're likely to end up with some childhood disease that you managed to miss when you were a kid. I never had strep, sinus infection, or erythema infectiosum in my life until I started working pædis. And trust me, kids diseases are hell on adults! Avoid them through good hygiene. Don't forget meticulous and thorough record keeping. Although you may start to feel more like a mom than a medic, you are still engaged in medical practise. Keep your medico-legal obligations in mind. They should provide you with an official treatment log, as is required by the ACA. But be prepared to keep even more detailed individual records on individual patients. Not all need it, but many will. Especially those that require evaluation of an injury or condition or an overnight observation. The treatment log book doesn't give you room for that, so have some blank lined charting paper available. And, of course, when you treat employees and staff, it requires a whole different set of records, for they are covered by OSHA. Read up on OSHA requirements ahead of time so you know the guidelines. Good luck, Bro! I love working kids camps. I wish I could make a good year round living at it. It's fun and rewarding and quite a challenge. If you go in with the right attitude and preparation, it will also be a valuable learning experience. You'll definitely be even better prepared the next time you do it.

If at any point you feel like you're losing them, whip out a Foley tray and ask for a volunteer. Always a crowd pleaser.

LMAO!! You sent me running to check the basic patch I received from NR back in October. No errors on that one. Darn it!

Every other medical profession utilises a private, non-governmental organisation to administrate their national examination. Why is it you feel that EMS is somehow incapable of doing so? And you may be the only person in America with any faith in DHS.

I agree with the concern. I'm only saying that concern does not rise to the level of doing a body cavity search of every patient you treat. Especially when you are just a first responder.

You are representing the entire EMS profession to the next generation. Don't embarrass us.