P_Instructor

All above responses are correct. The idea of getting into the field initially is the desire to wanting to help when it's needed. For the monetary aspect, again it's what you put into it, what you do with it, and how you perceive it. One must add that pre-hospital EMS is a great stepping stone towards other professions within the medical field, usually all that pay more, ie. RN, PA, MD, DO, Radiology, Administration, .......... I've been in EMS over 32 years, and just eke'd by on salary, but it has led me to teaching EMS full time, and I still continue to provide my field services part-time. (Better salary and bennies.......no, not benzo's). It's still again how you look at it.

Based on proper requests of further history and information obtained, this should lead to the aspect of visual/palpatory examination. However, full vaginal exam on female, no. Patients can be very vague in their complaints of discomfort in the pelvic region. A good paramedic should be able to acertain pertinent information with proper questioning to warrant a proper examination if needed as without the this, how the hell can they know what is really happening, and can they do anything for the problem. There are many things that you can inspect/palpate for so you have (no pun intended) a better handle on the situation (crowning, swelling, trauma, bleeding, drainage, etc.). There are proper times and improper times when examinations are needed. Either case, you should always have patient consent and hopefully a witness with you.

Could you send me your protocol on nebulized MS, even for the reason displayed?

Could we call this the "Gene Simmons Technique"?

IS ANY ONE ELSE OUT THERE CALLED AN AMBULANCE DRIVER .................. Yer dern tootin Roscoe. Also truck driver, cabbie, bed boss, and ambo ass...

I do agree. Reviewer's beware.

Well, you posted this just as I am about to begin the airway section of my Paramedic class. Personally, training institutions do teach the 'skills' of airway control, but I agree with you there is a lapse of instructors that don't teach the necessity of assessing for the appropriate response for this control. Personal opinion is many new (young and slightly experienced) instructors like to teach what you can do without why you do it. It is a shame that this happens. I agree within the other posts that you should only do what is best for the patient by fixing the problem first, any you need to assess what the real problem is. To many providers are using their protocols as 'Bibles' instead of what their real purpose is......'Guidelines'. How or why in the h*** does a provider perform these skills without really understanding what they are doing? I personally don't instruct this way, and my students need to know the big 'W's' in everything they do. Unfortunately, I guess I'm in the minorty of this type of instruction, and then don't have control of the student once they enter the work force. This does give the impression to your initial question in regards to training and the pros.....

Welcome and good luck.....remember on the test, keep is simple and by the book, SS, BSI, A, B, C........

I agree with the 'Herbmeister'. Make sure that all your policies are clear and that you understand them fully. The biggest thing is that you do not offer medical advise, but as stated to inform the patient of the potential risks of refusing medical care. Don't you make the decision that an ambulance is not needed, And finally, document everything with signatures. One little piece of jargon I always use with refusals after the patient is informed is that 'patient acknowledges understanding......"

Don't fret too much about it. Use the advice of the previous and practice. Spenac spells out the best formula for the drugs. Drip rates are easier. I'm currently instructing my P class in the math formulas, and many have difficulty, but with good, calm approach, it will come you you very easily. My best advise is to get everything into the 1, 10, 100, 1000 catagories. Master this, and it is a snap.

Are are good as long as the airway has patency. Each develop their own opinions on which device is preferred. Overall, the ETT is IMO the best, but again, as long as the airway is controlled. I have used them all.

We use it exclusively for all the scenarios stated before. It is more versatile than Diazepam and if given IM, is more readily absorbed. Then only initial problems we had was underdosing in seizures. This was identified and protocol changed. Have had no problems with it since. Good stuff.

Thanks to those responding. The idea of having a elevator key is good for cities where it's use is often needed. For further, we not only send in background checks, but require the necessary immunizations, adult/pediatric manditory reporter, health evaluation, and other items prior to be eligible for clinicals. This is required for both basic and advanced classes. Bravo!!!!!!!!!

Thanks, it is usually common for the checks prior to employment. Our program does do background checks at the beginning of our EMS classes and if bad 'hits' come back, this may be a deterrant to obtaining licensure/certification from the state EMS Bureau. I was just wondering if any other programs provide the checks for EMS. I know that many Nursing programs also do the checks.

It states he worked for the fire department.......Question for anyone, was there ever a background check (DCI, FBI, CIA, whatever....) performed on you at the beginning of your EMS class. I know that even cleared personnel can go bad, but I was just wondering if your programs made the initial check manditory to take/finish the class.

Come out and check the fresh air of the midwest......plenty of fishing and hunting areas......tryng to find the 150 acres could be possible.....Iowa/Nebraska/South Dakota baby!

Cool....I wish more of this type of thing would happen around here.

Relatively simple.....what do you have, and how would you treat it. Example: (caption) You have been dispatched to the residence of a 50 year old male. Your patient complains of severe chest pain rated as a 9 on 1-10 scale. He is very diaphoretic, cool, and ashen. Vitals are B/P 190/130, Resp 28 and shallow, Pulse 125. The patient states the pain started about 40 minutes ago and became worse. The patient has NKA and does not take any medications. The patient was working in his garden when pain first occurred. Provide oral treatment. (Strip) Sinus Tachycardia, no ectopics. The rhythm appears to be a Sinus Tachycardia. BSI, oxygen @ 15l/NRB, monitor, establish IV, 324mg ASA, NTG 0.4mg SL and reassess. No changes and B/P supportive, then 2nd NTG 0.4mg SL and reassess. If no changes and B/P supportive, 3rd NTG 0.4mg SL and reassess. If patient still having pain and vitals supportive, consider analgesic such as MS 2-4mg IV. Continue monitoring and transport. Keep it simple but complete. This example would be a MONA type of situation. Of course, this is my interpretation and opinion, and there could always be variations on how others would respond to your inquiry. Good luck.

Damn....if they go to the LED lighting, then the title of this business saga "As the Beacon Rotates" will have to be changed. Oh, well, the spin-off "As the Siren Wails" will always have it's place.............

Use the items that are outdated and are being tossed out.......no loss.......