Capman

Our service covers roughly 28,000 residents. It's a pretty large rural coverage area. we have 4 bases of operation and five crews of at least 1 paramedic and either an intermediate or basic. Responsibility breaks down like this I guess... It can vary since everybody rotates through the multiple bases and some coverage areas are larger for some of the bases than others. If you divided the amount by five crews however, it would be 5,600 per medic. As crews become busy at one base, the other bases are now responsible for those coverage areas as well until those crews free up again. It isn't uncommon for one crew to be responsible for the entire 28,000 residents until all of the rigs/crews get back in service.

That's what I'm thinking! I can't count the times that I've been paged out for "somebody not feeling well" only to discover upon arrival that they were in respiratory distress or "not feeling well" because of that pesky MI. Let's all stroll to the rig... It sounds like a BS call! :roll:

Every day. On a call is no place to find out that something is missing.

Good question! In the service I work for, we have not had any memos generated about idle time as of yet. We also see high hours of idle time. Our service covers about 1 dozen towns. This is divided among 4 bases. When a base is depleted of ambulance coverage due to calls, the neighboring base stages up at pre-determined locations, such as at town lines. Sometimes this is for hours on end. You can see where this would be a problem in Northern Maine where the temperatures can reach -70 in the winter and 100+ in the summer. Sitting in a rig that were shut off, would cause you to either fry or freeze. Not only is it inhospitable for the occupants/staff of the rig, it would ruin the meds and fluids as well. If administration wants you to stage/sit at the town line, then the rigs will idle.

Well, it's like this Ex'... It is easier on the veins, but the thing is with morphine is that many locations get it in pre-filled syringes. Many locations have gone away from morphine as well. In Maine, we are using Fentanyl instead of morphine. As I said though, for us it came in pre-filled syringes. Keep in mind that many meds you can dilute with NSS to a larger volume (say to 10 ml total), which makes pushing it over a couple of minutes easier to calculate. In your case, don't create 11 ml of solution, but instead if you are going to dilute 1 ml of Morphine into 10 ml of solution, first dump 1 ml of the saline (in a 10 ml pre-filled saline syringe) or if drawing up the saline, draw up 9 ml of saline and the 1 ml of morphine, making it 10 mg of morphine to 10 ml of saline. It keeps the ratio 1:1, making calculations much easier. I'm curious to know if you are still using morphine and if so, any talks about going to Fentanyl in the future. I'm also curious to know how it is packaged for you. Thanks, and hope this helps.

I understand what you are saying spen', but I'm not sold on that. There are many ways we can dish out our services. Cold, however; is not a preferred "serving".

If you didn't say Ruff', I would have. A shoulder to cry on, a hand to hold, and a thankful hug (to name a few) is what we call human compassion, and when appropriate; it IS part of the job.

Good advice firedoc, but there is a clear difference in the need to cover your ass and not needing to cover your ass! "Covering the ass" in this 'medics case would have been not to molest the girl in the first place. The only ass covering a "chaperon(e)" would have provided in this case would pertain to the removal of temptation or the inability to act on it. If this 'medic did actually commit this offense, then of course; there is no place for his "ass" in EMS in the first place.

Hockey is still popular in the USA, they just changed things a bit. They lost the ice, sticks, and puck. It became what is known as the UFC.

Megan' I have been in quite a few "go arounds" with quite a few patients. I wouldn't necessarily classify them as attacks. I see an attack as getting ambushed as I walk through the door of a house, as I exit my ambulance, or being charged in hostile situations. That has not happened. But as mentioned most have found or will find themselves in a physical situation due to a psyche', diabetic, and drunks to name a few. Let me add though, that I live in a fairly mellow part of the country. I'm sure that those who practice in the big cities have found themselves under attack quite frequently. My advice to you, is to always expect the unexpected this way your guard is never down. Good luck

jjones', It's pretty much protocol based. We really don't have the luxury of performing ad lib with our medications on emergencies. As for PIFT transfers where we are responsible for many medications, these sort of considerations are usually thought out by the physicians prior to the transport. I'm pretty sure however; that you were referring to the on board drug box though, and as mentioned, Epi' and Dopamine are all I can think of in the classic vasoconstrictive/vasopressor sense. If you could offer a little bit more to the question, we could probably go in depth just a bit more. I'm just not sure that I am answering this correctly for you as of yet. Thanks

This topic was brought up about a month ago, spawned mass debate, and revealed a lot of strong feelings about tattoos and their visibility in the medical profession. See this thread... http://www.emtcity.com/phpBB2/viewtopic.php?t=9934 I'm not going to lecture about the search function, but be prepared as I believe that lecture is imminent.

Well, we all wish her and you the best. Feel free to open discussions anytime.

Scar', They didn't list a price for that pin on the source website. Try this... http://www.classic-medallics.com/pins-occupational-pins.html

"even if its your radio shack science project," LOL Offshore. Yes, Yes! The Tandy, Explosive Vest Trainers Kit. Yeah, I'd probably report that too. The thing is, is that I am not looking for it.

Bingo! There it is! "Civil rights go out the window when it comes to terrorism". Well this is an "Everyone is a terrorist" mentality, and it is wrong. This only supports one theory. The terrorists have achieved what they have set out to do... Instill Terror!

Strippel, Congratulations on your advancement. Comfort level will come in time. do not expect it to arrive in your first week or month for that matter. Know your skills and be confident in them. I will share a little story about my first week as a paramedic where there was an incident when I doubted myself even though I was right. I followed the advice of a 10 year veteran paramedic who misinterpreted a cardiac rhythm for PSVT even though I called it right as a Vtach. (as if they are even close) However, having held my paramedic license for about a week, I second guessed myself due to the intimidation of contradicting the call of a veteran paramedic who would not budge on the possibility that it was anything else other than PSVT. It was one of the largest mistakes of my career and came close to costing me a license, but it was a valuable learning experience that I am not ashamed to share with others; so that it will not happen to others. The lesson here is about not second guessing yourself if you are confident in your skills. As soon as you doubt yourself, you open yourself up for this sort of incident. We all know how it feels at the paramedic level when for years we were the ones who looked at the paramedics for the answers and to handle those difficult situations. Now all of the sudden we find ourselves on the receiving end of those inquisitive glances. It is somewhat intimidating, but it will wear off eventually. Another last piece of advice I can offer you is if you run with basics, is to not sell them short of their capabilities. All too often I see this happen with various services and even within the service I work for. I will tell you that I would rather be with a good basic than with a mediocre paramedic. The point here is that from experience I will tell you that it is not too often I get overwhelmed by paramedic level care. Some of my most overwhelming situations have arisen out of situations that EMT basics are equipped to handle. So let them work and let them help you. Do not get wrapped up in one of those mentalities that acts like when you are with a basic, then you are alone. It couldn't be further from the truth. I would work with a good EMT basic any day. So keep these few pieces of advise on your mind as well as the other advice others offer. I wish you the best of luck and welcome you as a new paramedic.

Anthony' You seem as if you would make a great educator. You bring a lot of great information to the city and you are always willing to offer advice and help to the visitors here. Keep getting into those skills labs and other training scenarios to get your foot in the door. If I may make a suggestion to you, get in the next IC (instructor coordinator) course to obtain your IC license. It's only about a 45 hour course. That sets you up for bigger things such as being a PHTLS instructor and such. From there, if you do not have a degree, start taking some classes to obtain an associates degree as most colleges will require a degree and an IC license to teach at the academic level. I am a adjunct instructor for the Paramedic/EMS degree in Northern Maine. The college I work for requires both of these. I'm sure that many schools will be similar in what they require for full time instructors and adjunct instructors. If it seems like it is too much for you at this time, then you could still help out at all of the practical stations that take place and other things like that. It still gets your foot in the door. If you need any other information, let me know.

You are comparing apples to oranges Bushpig. What you are describing here is not what most of us are complaining about. The use of us as "information collectors" is. Helping in a situation is acceptable to some extent, but snooping and poking where we do not belong in attempt at finding something that more than likely will not be there is unacceptable.

I understand that Vent', but there is a difference between noticing something and looking for it. "Gathering information" for EMS providers is SAMPLE, OPQRST, and ... well, you get the idea. If there is something apparent in plain view, then I will do my job to report it. But I will not investigate or probe homes in attempt at finding something.

Stand there too long, and all of the cameras will be pointed in your direction. LOL I keep an updated pocket guide as new meds are continually being introduced faster than those books can keep up with them. But, they do help. I come across items that are not in the book from time to time, but usually family or the patient has the knowledge of what the medication is for. This of course does not help for the patient who has no clue about what they are taking, but for the most part; they usually do. Hope this helps some.

Nice find! Interesting topic. This one will create mass discussion for sure. If homeland security is going to start using us to police emergency scenes, then we will be thought of and treated as cops by the general public. This, as I see it; has potential for the hinderance of patient care to some extent. What's interesting is that this article even indicates the potential for breaching public trust. What's even more interesting the consequence for breaching public trust causes no concern in their eyes for patient care but rather for the loss of a "collection asset". Here is the direct quote: ad hoc collection practices that breach the public’s trust and expectation of medical confidentiality may result in the loss of this valuable collection asset or the creation of inordinately risk-averse TEWG oversight mechanisms. Now... Of course If you get called to a scene where someone has lost a limb or two and you notice that this person was building pipe bombs 10 feet away from where he was laying. Then of course you report it. Chances are there are police on the scene anyway in a situation like this. But what I get out of this article is when they label us as "information collectors", I get that they want us to go above and beyond what is directly related to patient care when they refer to "Collection". I can just see it now: Let's rework the Acronym; SAMPLE history... Feel free to add. S - signs of terrorist activity or intent, Explosive vests, Rocket launchers, Charred flags, etc. A M P L E Seriously though, I'm not sure I am comfortable with this one. Will be interesting to see how it pans out. The funny thing is, that I do not think that terrorists will be calling the ambulance for boo boos when there ultimate quest is human sacrifice anyway.

Kat', Do you at least have a clinical coordinator to handle ALS incidents? Or is it just a basic to handle all of the aspects pertaining to the service?