medicgirl05

There are many different views on this topis from people much smarter than me but this is my experience and opinion. I was an EMT-B for 3 years before certifying as a paramedic. I don't think there is a ton of stuff you can really learn at the EMT-B level, other than dealing with people. My opinion is that it is great to be a Basic to get your feet wet, but to set a time frame to be a basic sounds pretty silly. If you want to be a paramedic go for it. The experience you obtain as a basic wont necessarily prepare you for that. So start medic school, it will take at least a year and in that time you will do clinical time that will be much more valuable than riding the truck as a Basic. JMO though and I'm sure you will get many others. Good luck to you!

Our protocols don't allow for pain management if there is an altered level of consciousness or for abdominal pain. Other than that we are pretty much allowed to medicate what we choose. We also have great medical directors who are always a phone call away, so if I am unsure if I can medicate I can make a phone call. She usually lets me do what I think is right. I did medicate a bilateral calcaneous fracture with a pelvic fracture that the nurses gave me some grief about, but I stand by the desicion. If my patient is in pain and I can fix it I am going to try!

Is he on meds to prevent the SVT? We have a pre-teen patient who has episodes of SVT when she is noncompliant with her meds due to family that would rather smoke coarettes than buy her the meds. Her SVT always happens around 7PM which I've never thought about before...She is otherwise asymptomatic. Complains of her chest feeling "funny" but denies pain. I'm wondering if it may be a similar situation? Is he on meds to prevent the SVT? We have a pre-teen patient who has episodes of SVT when she is noncompliant with her meds due to family that would rather smoke coarettes than buy her the meds. Her SVT always happens around 7PM which I've never thought about before...She is otherwise asymptomatic. Complains of her chest feeling "funny" but denies pain. I'm wondering if it may be a similar situation?

Usually in the summer months we try to keep some gatorade in the truck for hydration, especially lately with all the fire standbys we have been going to. It is pretty funny that here we try to find snacks that no one else will eat. Mostly if you keep fruit or yogurt you are in the clear, but if you keep cookies or something yummy everyone else will help themselves.

Yes. I have been to many suicides, as both a basic and a medic, and it still amazes me the extremes of emotion that are experienced by family. People react very differently and you just never know how the conversation will go.

I believe this is the absolute hardest thing I have had to do. It is a balancing act to keep you emotions where they need to be. These moments are what stick in my mind from such calls. Plus I was never really prepared for how to do it, and it hasn't gotten any easier with experience.

The example that comes to mind is dehydration. Symptoms of dehydration are tachycardia and hypotension. I'm sure there are more examples but this is all that pops into my mind.

Do you know the definition of arrhhythmia SD? Any abnormal heart rhythm. Don't chew the poor kid out for wanting to listen to them...I have never shocked or done compressions on many arrhythmias; including A-fib and the occasional PVC. Nerd-yes occasionally you can hear an arrhythmia. A-fib has an irregular beat which you can usually hear. Now I wouldn't document an irregular rhythm from auscultation, as I don't know how precise it would be without special training. The only dumb question is the one that goes unasked.

All the scenarios I ran in school the patient either was fixed after 2 or 3 interventions or they died. I never thought I would work so hard on a patient for nothing... They just don't tell you about the hard parts, or maybe I missed that particular class...

I recently had a patient that we eneded up defibrillating 14 times. V-fib over and over again. Used all my available meds. Treatment and transport time was one hour and a half and we got a pulse back once. I was so sick of V-fib that I pleaded for a different rhythmof any type. We finally got a PEA at a rate of about 30. They called her after twenty more minutes in the ER. She was STILL in PEA. They never EVER told me of any such scenario in school. It got to the point where my partner and I were completely out of ideas and all we could do was CPR. ER doc had never seen such a persistent V-fib either.

Exactly! That's why I can't do it as often as I'd like! :-)

Hi Grady! I'm also from Texas. Gotta love it! :-) I'm curious, do you already have work lined out, my curiosity is because I am currently exploring the idea of working overseas/offshore and all the companies I've looked at require experience at the paramedic level....What company are you going with? Thanks!

I know how frustrating such a situation is... I get very agitated when a patient has the nerve to say "I only called y'all so I don't have to wait to be seen". I, however, don't change my treatment of said patient other than when we get to the ER I may kindly inform the nursing staff the patient could be triaged before room assignment...They usually get the hint that the patient isn't "emergent" but that lets them make the final determination if the patient can be sent to the waiting room. Most of the nurses we deal with on a regular basis will proceed to tell the patient the purpose of 911 and EMS, clearing us from getting dinged with "refusing to transport." The bad part-patients who do not need ambulances are the majority of our calls, so I've pretty much just learned to deal with it. Only time it really sucks is when both of our ambulances are on BS calls and something serious gets toned out. It takes an hour for mutual aid to respond to our county; and a typical call for us, with transport times, takes 2 hours...

I think one of the most important things I had when I started off was a list of all the area ER codes. When I started it seemed as though everyone just assumed I knew the codes and were frustrated when I asked. We have 5 ER's that we go to and every one has a different code. When I started I carried all sorts of things...Now I carry trauma shears, a field guide, and pens. I find that pretty much does the trick for me.

Thanks Dwayne for the input. It is much appreciated!

Well thanks for the input...I do have a female friend who is working with the same company and is in Camp Dwyer. I'm not able to talk to her much but she says it's great...says she should have done it years ago...The contract is for one year with R&R about 6 months thru. I am still waiting to hear from the company I've submitted my app and resume and letters of reccomendation to. The fellow I talked to said I have a pretty good chance of being offered a contract as I have no criminal record at all... I'm just on the fence as to wether it is a good idea or not... I think the experience would be great, the people I'd get to meet would be interesting, it's a great opportunity to grow as a person, and the money sounds good too.

I would never ask for a discount..I think that is extremely unprofessional. We sometimes get free fountain drinks at a local convenience store, We get a free appetizer at a local restaurant, Chick Fil A gives us half off, and a local breakfast taco place also gives half off. If any of the employees charge regular price we pay. They are offering a courtesy by giving discounted food, they are not required to and even if I am given that courtesy half the time I still appreciate it.

What did the patient look like? Swelling/redness to his airway? Rash? Did the BVM seem effective in maintaining the patients airway? If not, do you have any alternative airway devices? Did you have time for Benadryl at some point? What did his lungs sounds like with ventilation? I have a question, the patient went straight from bradycardia into asystole? No shockable rhythms or PEA in between? Just a curiosity thing... Also, it is much easier to sit back after an event like that and criticize what you did, or think about what could have been done differently, and that is fine, just don't get too caught up in it.

I would suggest trauma shears. That is the only piece of equipment I personally carry(well that and a few pens and a field guide). I guess it depends where she works but I don't have a need to carry an O2 wrench on me as it is usually attached to our O2 bottles.