Dustdevil

Ever the optimist, eh? Remember, there is a very fine line between a vision and a hallucination. :wink:

I am not sure what the purpose of your question is. It would be helpful to know if you are just taking a statistical survey, or if you are looking for some feedback on field usage. I'll go ahead and chime in, in case you wanted usage feedback. I am not currently in the field, so I can't speak for what is currently being done here. However, when I left the field, we were carrying both Nubain and Stadol (as well as Morphine, Demerol, and Versed) and I had great luck with both. It is all about choosing the right drug for the patient. So long as this is done appropriately, both have great efficacy. I used them mostly on isolated musculoskeletal injuries. Especially fx hips and the like. I have used Stadol myself and I can assure you it worked well on the worst pain I ever had in my life. However, at the upper limits of dosage, the side-effects can be unpredictable. Patient A receiving 2mg may experience relief with no significant side-effects, while Patient B gets completely and unarousably knocked out by the same 2mg. And occasionally, 2mg will send you into a full-blown hallucinogenic "bad trip" that requires patient restraints. And, unlike with narcotics, you are left with no antidote when you have a side effect with Nubain or Stadol.

Incorrect. If a lay person can't do it, it is ALS. All pre-hospital pharmacology involving prescribed drugs is ADVANCED Life Support. Apparently you are confusing the acronyms BLS, and EMT. They are not interchangeable terms. EMT does not necessarily equal BLS. And you cheapen both the seriousness of the interventions and the EMT's who are performing them by calling them "BLS" just because they are an EMT. I thought you were the one against basic bashing here. Soooo... what exactly does that have to do with what I said? :?

No. It would be horrible. Because then EMS would be even farther dumbed down to the lowest common denominator and restrict those progressive systems from excelling. I believe the word is socialism.

I hope losers with 120 hours of first aid training administering drugs to people never gains acceptance in my area. :? And regardless of what semantic label you choose to place on the procedure or the provider, pharmacology is still ADVANCED Life Support.

One-hundred to two-hundred and fifty hours of first aid doesn't even put you ON the totem pole, as far as I am concerned. :roll:

Definitely! =D>

Minus 5 for posting an ALS topic in the BLS forum. Yes, we know you are talking about EMT's, but pharmacology is ALS regardless of who is performing it.

NC, you're really reaching now. Everybody in America has that very same "authority." Therefore, it's not authority at all. It is simply the same right of every person. Not to mention the absurdity of believing the badge is what gives you that "authority" or the belief that mental incompetents care about your badge. Funny, I've never seen anybody in the psych wards wearing a badge. In fact, I have never seen ANY other healthcare professional wearing a badge, yet they seem to have functioned just fine for hundreds of years longer than we have. I suppose it is only medics that feel impotent to practise their craft without a penis extension. We're the ones who are going to show all the other medical professionals how things should be done, right? :roll: If you, like our new friend here, had read the link that Admin provided, you would know that you are not saying anything new. And what you are saying has been thoroughly thrashed into embarrassing defeat in at least two other threads. Stick with that theory if you wish. But the bottom line is that anybody with that point of view simply has no better justification than a self-serving desire to look "cool."

Funny how everybody who hears this old line thinks it's something innovative and profound. :roll: He was trying to make you feel better about yourself. EMT's get no pay or respect, so a lot of instructors toss you a lot of rhetorical bones to try and pump you up and make you enthusiastic about the simple first aid course you just spent $2000 dollars for. But it's crap. And taking it to heart in the field will very quickly mark you as an idiot and a troublemaker, leaving you alienated from most of your potential partners. An EMT brings nothing magical to the situation that "saves" paramedics. There is nothing special about an EMT that allows them to "save" their partner where another paramedic could not have done so. Why the heck would I want a "saviour" when I could have a full partner who can share in the total care of the patient instead of just load my cot and drive my ambulance? Your job is not to "save" your paramedic. Your job is to be a PARTNER to the paramedic. If you walk around with the saviour attitude, your career is going to be very short. The problem is, a truly "good" EMT is about as common as a virgin in a whorehouse. Their education sucks. Their experience is usually horribly structured. And the field overwhelmingly attracts idiots to begin with. Three strikes. Damn rare to find an EMT with enough knowledge or common sense to function competently, much less supervise others critically. Just read the idiotic posts on this board by EMT's bragging about the things they do NOT do for their patients because they know better than their instructors. Not to mention all the stuff they think they SHOULD be able to do to patients because they have a whole month of night school under their belt. Gimme' a break. And no, I am not terribly impressed with most medics either. They suffer from the same three critical failures as EMT's mentioned above. But at least they have a broader foundation and frame of reference from which to base their decisions. In my experience, it would be extremely, extremely rare that an EMT "saves" a Paramedic with medical or operational input. I have never seen it happen. Sure, I've had an EMT make my job a lot easier and more pleasant by knowing WTF she was doing and anticipating my needs. It's wonderful when it happens. But it's certainly not synonymous with "saving" the medic. Luckily for me, I had been a medic for many years before I ever had to partner with an EMT. And, in fact, it is absurd that any rookie medic in this country is paired with just a basic. Such a structure is the blind leading the blind. It should be a crime. And if your agency is doing it, your agency sucks! The answers to the original question have addressed it quite well. Of course you have the right to question anything you perceive to be incorrect or unusual. Absolutely. You are part of the team and share responsibility for the patient. There are a lot of stupid, lazy, and incompetent medics out there. There are a lot of tired and sleepy and stressed out medics out there. And there are a lot of medics out there who simply have the occasional brain fart. A *good* EMT can indeed make a difference, so take that responsibility seriously. But don't let it go to your head. Use some tact in your communications, because there is a very good chance that what you think doesn't look right is actually absolutely correct from a paramedic perspective and you are jeopardising your relationship with both your partner and your patient by being a mouthy arsehole and spouting off ignorant crap with some sense of self-importance. Your job is to make sure the patient is being treated right, not to try and prove you are better than your partner. And if your partner doesn't agree with your observation or suggestion, tough. Suck it up and do as you are told. Don't stand there and argue with me about whether we're going to use a long board or a scoop stretcher. Don't tell me what your instructor told you. Don't tell me what your former partner told you. Do what I tell you, when I tell you to do it, or hit the clock. There were at least 20 other people in your EMT class, and most of them are still looking for a job. And there is another class graduating next week. You are expendable and very easily replaced. If you're going to make a stand over an issue, it had better be something EXTREMELY important and that you are ABSOLUTELY positive of. Because about the second time you make an arse of yourself over some trivial issue that you have neither the education nor the experience to even speculate upon, you become a liability to me and you will be back at Taco Bell within the week.

I think people should choose their uniform based on more professional considerations than what idiots on television are doing. And I think this topic has been discussed to DEATH, in a not so civil fashion, on this board, as well as every other EMS forum ever started. And I think I won't be the only one to suggest you use the search function to find the previous discussions to save a rematch of the previous fights. Yeah, sure they look professional. Problem is, it's the wrong profession. You have no authority. You are supposed to be a MEDICAL professional. Nothing more. Concentrate on being that or choose a more appropriate profession. [stream:0b233fd7eb]http://www.darryl.com/badges/bsbadges.wav[/stream:0b233fd7eb]

In other words, you can't. And it certainly has not happened in this issue. My stance has remained consistent for many years. Wrong again. I have spelled labour with a U since before you were born, when Australian and South African relatives influenced me and I began spelling many, many words English style. This is not a recent affectation. But, if you can figure it out, you are welcome to use the search function to check my posts if you like. Be sure to come back and admit to everybody that you were full of $hit afterwards. Like any intelligent professional, I will change my views on issues when presented with evidence that supports a better way. And when that happens, I make a big deal of it, so nobody misses it. But hypocrisy or "doubling back" is something you won't find. But again, have fun trying! We need more people making arses of themselves here. And speaking of hypocrisy, try using spell check next time you go criticising other people's spelling. Your illiterate rambling gave me a headache. :roll:

Texas allows local medical directors to determine scope of practice, so it may well be happening some places where they suckered some old fart GP with OBS to sign off on protocols. I can guarantee you it is not happening at Beaumont EMS, which is one of the best in the state. The director and clinical coordinators there are two very, very sharp professionals whom I have the utmost respect for. Must be a podunk rural service or a transfer service that is jumping runs.

Wear a helmet. Wear body armour. And stay in the captain's chair whenever possible. Those three simple steps would cut the mortality and morbidity rate astronomically. But, just like the magic Winter Park seat and any safety harnesses, people are too stupid and too lazy to utilise them, so really, any efforts to make ambos more safe are futile. You just simply have to hire smarter medics.

Again I agree with VS. Figuring out how to "use" the device is not the issue. It is figuring out how to utilise the information you get from the device that requires education. And that education involves a lot more than a crash course in a specific device. It requires a thorough foundation in physiology. If your personnel do not have that foundation, then save your money because they have no business with the Pulse Ox.

Error :roll:

It is. It's not education. It's monkey training that can be done in a couple of shifts on the ambo. It is pointless to take up valuable education time with such nonsense. I would have very little respect for any PCP student who didn't figure it all out on his or her own during preceptorship without having to sit through a semester of class over it. What's next, spend a semester teaching PCP's how to check the oil and tire pressure on the ambo? :roll:

I think I have just found my new best friend! :love10:

Just like in the US, most people want the fastest school instead of the best school, I would suspect that in Ontario, more people would be attracted by a school offering a more practically based program than a didactically based program. This is very unfortunate. Practical skills in education are very overrated, and quite frankly, overemphasised in many programs. Think about it. Skills will always get better with practice. That is a given. The longer you perform them, the better you get at them. However, you are not going to get any smarter. And your theoretical education, for all practical purposes, stops when you graduate. It will not get better with practice. In fact, it starts to deteriorate the day you graduate. Given that choice, if there is a significant difference in programs, I'm going for the more theoretical educational than some school that concentrates on skills.

Increased accident rate. Cops have been constantly crashing and dying because of driving while watching their MDT. I hope systems that put these things in their units have the sense to mount them visible only to the passenger seat. But I seriously doubt it. Certainly wouldn't put one in my units visible to the driver. I care more about my people than to do something that stupid.

If that's because they never run MVA's, great. If they are running MVA's and not using them, RUN from that service ASAP. It's a bunch of lazy, ignorant, unprofessional losers who will be a bad influence on you and eventually get you involved in a lawsuit.

Thank you, Shadow. Now, if you'll please go to this thread, we have some lovely gifts for you. http://www.emtcity.com/phpBB2/viewtopic.ph...934&start=0

That's comforting to know. I would definitely like to know to what standard these nets are tested to, if at all. I know in my wreck, the patient was semi sitting on the cot, and when we impacted (somewhere between 60 and 75 mph), the 180 lb patient's weight and momentum snapped the metal rod that holds up the head of the cot smooth in two, where he ended up supine instead of upright. And I was figuring that rod was a lot stronger than any little clips holding the nets in place.

Yeah, I was focusing only on major metropolitan city services, not the suburban places like Cypress Creek. Cy Creek is definitely good. Also in Texas, Austin-Travis County and Beaumont are excellent, all paramedic (no basics), high volume services that would be well worth a look. No doubt. Seattle is not without its problems. From stories I get, their people tend to cop an attitude and become lazy since they are allowed to dump the lowly, unworthy, non-emergent patients on private ambos at will. Still, if you get a good crew, your experience should be quality, and structurally, the service is an excellent model. Heard too much bad stuff about Boston. The Northeast in general sucks. Atlanta is good. Hospital based, which always makes for a beneficial situation. Definitely worth checking out for a Southern perspective. I heard great things about KC back years ago, but I am not familiar with them now. I know Kansas has some of the best educational standards in the country currently (although I think Missouri is still behind the 8 ball), so KC, Kansas is worth looking into. KC, MO or St. Louis are nice places to visit, so worth a look too. Too late to go to Phoenix this year. Too hot already. And you'd have a very hard time convincing me any FD service rates up there as a shining example of excellence anyhow. Especially with the dip$hit chief they have. I'm not sure exactly what the goal of your visit is. If you want a good overall view of US EMS in general, you won't find it in any one place. The variation here is huge and disgusting. But there are certainly great services that do things completely different from Seattle. If you have time to check out a couple different places, I would definitely recommend it.