NYCEMS9115

Welcome to the City... Good luck on your EMT... Any desire to go into Police work: Local, State, or Federal?

Welcome aboard.... Which County?

Not if they are in the Union...

They are accredited through the NLNAC: www.nlnac.org, the CHEA: www.chea.org, NYS DOE: www.nysed.com, and the MSCHE: www.msche.org... It is recognized by the US Secretary of Education: www.ed.gov... www.excelsior.edu/accreditation The .edu domain is for Accredited Educational US institutions. It is managed under the US Dept of Commerce... Remember the job market is not full of positions. We had the highest unemployment rate just a few months ago... It's hard for everyone... Education and experience will seperate you from the next applicant...

www.excelsior.edu Excelsior College has an Experienced Allied Health Professional "Bridge Program" to RN... It's "Faster" because Patient Contact Hours (Clinicals) are reduced; there are Patient Contact time for Nursing Skills learning and practice (Manikins first). You will need to complete the Pre-Requisites for the ASN before you can take the Nursing Concept Courses... Their BSN is for RNs with an ASN, RNs without a Degree, and RNs with other Degree(s)... They do have a MSN Program also... However, it is not an easier route. I find it more difficult because there is no Professor to ask questions; there is no curve or extra credit. There is one Final Exam. Your exam result will determine the Grade you get. Excelsior has other College Courses and Majors... Just concentrated on the EMT-B first... Then work or volly for experience... Your State Certification means you met the Basic Standards of Basic Life Support in regards to EMS Care... Good luck....

Nice article... Thank you for sharing... I took a Bike Medic Course when I was at Lenox Hill Hospital in 2000 thru Jamaica Hospital Center. It was a 1 Day Course on proper Bicycle Operations in EMS: Mounting, dis-mounting, stopping, up and down steps, stationary pedaling, long distance riding, speed riding, bike safety, bike repairs, & etc... It was fun; they provided breakfast & lunch... Apparently, it was a National Organization. Can't remember the Alphabet Title...

http://emsseo.com/2011/01/free-ems-downloads/ Good luck on your State and NREMT Exam... The downloads are very good. Especially, the EMS Study Guide... The guy who started this site, years ago, was my boss at my very first NYC Hospital Based EMS, when I became a Paramedic. I also worked with him at another Hospital EMS... He's well respected in the NYC/NYS EMS Community... Forgot to mention; it's FREE... You can re-read the EMT book. Make sure you know the Objectives for each Chapter... If there's a CD-ROM, go over the material on it... If you have a Workbook w/ the Textbook; do all the work on it... Q&A with other classmates & instructors... This is a good way to prepare...

It looks like a nice piece of equipment... Let me(us) know how you like it... I checked it on my mobile; so my search is limited... Wish it did Capnography...

A Lawsuit can be made for almost any reason. This will be one of them. All the Company needs to defend itself are the Policy and Procedures stating that and the letter signed by the new hire that he/she received the P&P. Plus, he/she has too find a lawyer willing to take the case and he/she better have a solid case. Not too many lawyers do Pro-bonno work... What the Company has to hope for is that the new hire doesn't try to collect unemployment. NYS, tends to give terminated even 1 day on the job) Employees unemployment, even if they were justly terminated. Ex. I fired a guy for driving and using his cell phone; have video to prove it. He almost hit a pedestrian crossing on the crosswalk. He still received unemployment. Another guy was fired for fake Doctor's notes. Still got unemployment. One guy stole patient controlled substances. He tested positive for it. Reported it to NYS. Lost his certification; no jail time, probation. He got the check. This girl, nicknamed "Tardy Smurf" was late more than 6 times (excessively late; I give a 15minute window), 4x no call-no show, & banged out just before the start of her tour 5x: all within 3 months. She was canned; she got unemployment. Another guy brought the truck back to base w/o permission; took off his uniform and threaten to kill an office member. Popo came to diffuse the situation. He stood the night in lockup and rec'd probation. He was gone that day; he has unemployment. It's easier to get unemployment for being fired than it is to win a lawsuit for being terminated...

Lung Sounds, Capillary Refill, Vital Signs, Skin: color, temperature, & condition, AVPU, A/O?, PMH, Allergies, Medications, HPI, OPRST (if there's pain). Then we can think of ALS treatments but BLS maneuvers should have been started already before your ABCs were done: O2 via NRM or BVM (OPA?)... Not enough information...

I run 11 BLS & 3 ALS (1 EMT & 1 EMT-P) during the day M-F; 1 BLS & 1 ALS on the overnights Sun-Sat. On Sat during the day there's 5 BLS & 2 ALS. On Sun during the day there's 3 BLS & 1 ALS. The day tours are 13 1/3hrs. The overnight tours are 8hrs. That's a lot of $$$.. (This is not the salary) Say the EMTs are paid $10 and the EMT-Ps are paid $20 & you want to run one ALS (EMT & EMT-P) crew 24hours; looking at pay for the 24hrs, it is $720 on salary alone. For BLS it's $480. This doesn't include: health benefits, time-off, fuel, insurance, supplies, equipment, communication, & other costs; just to run 1 Ambulance 24hrs. Daily Operating costs are a lot. You're going to need more than 1 HD patient (that's only 1RT transport 3x week; for 6 transports). Hopefully, the HD patient has MCR (Medicare), most should but for EMS/PHC, it's MCR Part B we want. MCR Part A doesn't cover Ambulance Transportation. If you do get Doctor's Office and Clinics to call you for patient transportations to their office(s); you hope they have MK (Medicaid) because MCR doesn't pay for Ambulances going to Doctor's Appointments. Also, for Non-Emergency Transports, a PCS (Physician Certificate Statement) mush be filled, signed, printed, & dated by a Healthcare Practitioner stating/certifying that the patient is Ambulance necessary. If you're luckily enough to get Hospital Discharges; in NYS, the PCS must be generated but there is a NYS MK Pilot Form (which is a pink form) that is sent from NYS MK and the Hospital Practitioner (SW, MD, RN/CW, PA, NP) must sign before the Ambulance Company will get paid (this is to verify that the Hospital called for Ambulance Services & MK sends it months later). Reason being; a patient can not call for Non Emergency Transportation. For Emergency Calls going to an ER; anyone can call. In addition, for MCR patient(s), if there's a transport where the drop-off is out of your coverage area: you will have to collect for mileage. MCR will pay the base rate and 1 mile traveled; any additional miles traveled must be paid for by the patient or their Representative at the MCR discount rate of $7/mile... That's just the Entitlement Programs. How about them HMO/CMO/PPO/EPOs? For Emergencies going to the ER, not a big deal but for Non Emergencies; most need Prior Authorization. The Caller (Health Facility) must call the patient's insurance and request for Authorization to get Ambulance Services. It can be a difficult task. They have to prove necessity to the HMO (it is up to the Private Insurance if excessive mileage will be covered). Hospital to Hospital (IFT/Interfacility Transport(s) are not covered by any Insurance (for the most part); it's a Bill Hospital (I owe you) because of the DRG (Diagnosis Related Groups); continuity of care (care has not been completed by the first/sending Hospital; care needs to be continued at another Hospital due to capabilities). You can not bill the patient for these types of transports. You can not bill a patient who has insurance; where the Services provided are covered by their plan... Medical Coding & Billing Personnel should be on staff; billing can get really crazy and confusing... Sorry for being a mood killer... Check out this new article from JEMS; it's little bit old. My company has been dealing with this for months (really for years)... http://www.jems.com/article/ems-insider/ambulance-billing-reimbursement-update Click onto to the CMS link on Ambulance Fee Schedule...

Advertisement... Company name on Business Cards, Pens, Pads, Post-its, & Calendars. Maybe on rulers, mugs, and magnets... Have a website... Go to Senior Centers to do free Vitals/BPs... Go to Primary Care/Internists... BP screenings for Church Parishioners... It's going to take a lot of money... It's not an easy business to start or run.... Good Luck...

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040487/

Check out Wake County, NC EMS... They are very progressive EMS Service. They've established an Advance Practice Paramedic... Check it out... Email their Chief; he will respond quickly... He's a contributing author for EMS World... The Medical Director is well known in the EMS Community... http://www.wakegov.com/ems/staff/app.htm Wished NYC was more like Wake Co. EMS. We're so behind...

Were not just talking about short transports; how bout on scene time and enroute times. Also, we tend to negate; how long before the Ambulance was called. In the NH (Most of us know their MO), patient's illness and/or injury has been occurring for a little. So, many of the times the CVA and MI TPA w/in 3 hours is out the window... Of course, not all NHs are like that. However, some are and that's too many... It will be expensive like any Advancement. Healthcare and Healthcare Cost & Reimbursements are different arguments but Costs and Reimbursements seem to be the reason why some do not move forward...

Prayers with your Father.... Speedy recovery... Godspeed...

Flight Nurse is a great goal. Since your set to attend College; continue that route and get your Prereqs for Nursing. Get you're ASN since you've already mentioned the Associates. With an ASN, you're still a RN. Then once you become a RN; apply, apply, and apply. Jobs are not that easy to get; so while in Nursing School, make sure you do well on your clinicals (Nurse Mgrs do see what students are doing on their Unit. Preceptors are RNs and may put in a good word). Take the New Grad Nursing Program. You can work as a Graduated Nurse while you what for the NCLEX. Take tutorial NCLEX courses (Regardless of when that computer shuts off, you won't know if you've passed); be prepared, it's a tough exam. As for a CCRN/Flight Nurse; you'll need to have worked in a Critical Care setting. The CCRN is a additional test/credentialing. Since, jobs are not abundant, you can't be choosy neither. The basic Nursing Program doesn't prepare you to work in a Critical Care setting. Every Hospital which hires RNs to work on these Intensive/Critical Care Units, go through an In-house Critical Care Course (Usually 3months long). If you want to become an EMT; you can take it during your Summer Break. Google for the nearest course (It maybe free, NYS has Programs that offer free EMT Course). You can always do the Paramedic later. However, the Paramedic is intense (Meaning you'll have no time for much of anything else). If your College offers both then take all the Prereqs; they're usually very similar. Jobs are not abundant neither. The 1 year you will have invested to become a Paramedic, will be so worth it. It is difficult to juggle working as a RN and going to school to be a Paramedic than it is to be a Paramedic and going to school to be a RN. Reason is that they have Adult Continuing Education (Excelsior College) which offers the ASN/BSN for Experienced Allied Health Professionals. Clinicals (Rotations) are waived because of your life experience. The Paramedic can take the CCEMTP (The Prereqs are: an EMT-P, Ltr of Rec, & Proof of Employment), very similar to the CCRN. The two are very intense (Meaning, there is a lot of studying and testing involved) Programs. With the CCEMTP, you're a Flight Medic. It is really up to you. I hope I've provided some information to assist you in your decision making. Just remember, you have to work until 67, you can always go back to school to get another Degree but get your Degree now. It is offered for Paramedics and RN; the easy way out is Certificate with no Degree. you have to think about your future. If you want to move up the ladder into Management, a Degree will almost be required... Just to give you my history (It may motivate you). I'm 35 y/o. I dropped out of HS. Got my GED in 95. Became a NYS EMT in 95. Worked in Private & Volunteer Ambulances. Became a NYS EMT-P in 98. Worked in NYC Hospital Based EMSs. Became an Instructor in 02. Became an EMS Mgr at NYC Hospital Based EMS in 06. Then I became a Mgr at a Private Ambulance in 08. Received my AAS in 08. Receiving my ASN in 12. Will go for my BS in the Fall of 12. At my pace, I will get my BPS when I'm 40y/o. I will still have to work another 27 years. So, it's never too late. I will pursue a Graduate Degree and maybe a Doctorate. My goal is to get my MS by the time I'm 50... Good luck to you....

http://www.emsworld.com/print/EMS-World/How-to-Succeed-in-Paramedic-Class/1$17097 It's really up to you. The Paramedic Program is hard; hard on your social, family, and personal life. There's a lot of rotations to do from ER to Ambulance to ICU to OR to OB to Psych to Morgue to Lab to etc. Working full-time makes it quite challenging. For many, it's impossible to juggle school and work. Some programs are College based and students will not be allowed to take the Paramedic without first completing the Prerequisites... EMT-I is Basic ALS Care. It depends on if it is the I85 or I99; still both basic ALS Care. It requires a lot less school time and clinical time. Working FT will be very possible. Your life will not stop as a result of the I class. There are no degrees for the Intermediate... Good luck....

Try ecg library: http://www.ecglibrary.com/ecghome.html It is free and you can have it saved as a bookmark. Another angle to review ecg... Good luck...

http://www.emsworld.com/print/EMS-World/How-to-Succeed-in-Paramedic-Class/1$17097

This is not FDA approved but seems it will be in the distant future for Paramedics in the U.S. This will be great thing to have in PHC. Consider we in the Private Transports deal with "Septic" patients in the NH. God knows how long they've been hypo-perfusing... http://www.jems.com/article/patient-care/measuring-lactate-prehospital

The dos and don'ts of transporting children in ambulances... http://www.ems1.com/pediatric-care/articles/756441-The-dos-and-donts-of-transporting-children-in-ambulances Pediatric patients need to be secured while in the Ambulance. As everyone should be in a MV...

Nowadays in NYC/FDNY EMS Cardiac Arrest will have a Conditions (EMS Lt.) Or DC (Duty Capt. If Lt. not 10-8) respond. Its been like this for 4 years now... So, it's more reasons to dot your Is and cross your Ts.... With no disrespect to the Original Poster; intoxicated people or under the influence people usually fib on the amount of alcohol they consumed...

Welcome aboard!!! Have fun here...

There isn't one book. Doctors are always reading, viewing, and listening to new studies. Medicine is ever-changing. That's why we refresh/re-certify. Things change. Besides working elsewhere: how about getting the ultimate ABC Certification for Paramedics? The CCEMTP. If you do not have a degree; get your AAS in Paramedics. If you have a Degree go for a Graduate Degree. All in Health Related Majors like: RN (then you can take the Program to be a CRNA, ARNP. With that you can go for the DNP), PA, or MD/DO. Allied Professionals like: RRT, PT, OT, etc... I don't know your educational background, other than being an EMT-P. The Paramedic Certification alone is just a big step in "Medicine". Unfortunately, you are restricted to the "Ambulance" field. If you want to be a better Paramedic? Work/Volly, attend CMEs, attend workshops in EMS Conferences, read EMS Magazines, debrief with fellow EMS Providers, check up on patient's conditions after the call, speak to Nurses and Practitioners about the patient you brought in, watch how the ER assesses and treats the patient you brought in, read other Medical Journals, QA/QI sessions, do rounds with Practitioners, do shifts in Telemetry, teach in an EMS Program, teach AHA Programs, when your in the ER and another crew brings in an interesting case; watch and listen, attend Call Review, look up conditions and medications, do practice exams online, watch medical Webcats, watch Grey's Anatomy (I'm kidding), etc... There's so much out there to make you a better EMS Provider. There's so much to learn; no matter how long you've been in EMS, there's a lot to learn. If you think you've seen it all, you're mistaken... "You" meaning EMS as a group; not you... http://www.google.com/m/products/desc?oe=UTF-8&source=desktop&client=ms-rim&q=secrets+of+emergency+medicine&hl=en&cid=16358601769357554021 Awesome book... This would be a book you're looking for but no books are absolute... Good reading....