nsmedic393

I think dj is spot on here. If I'm working with a new basic or even a basic that I have never met before I NEED to be absolutely sure of where that person stands before we get put into a situation where a patients life could be effected by it. The highest level provider is responsible for AALL patient care regardless if they are in the front or back, attending or not. If something gets missed or a tx is not performed that its going to fall onto the ALS proveder and, "i thought my basic had it covered" is not going to be a good enough excuse. I NEED to know if the person I am working with is actually someone who will be usefull and know a thing or two about patient care or if they are just a couple hundred pounds to fill a seat for twelve hours. While you are in the middle of a hairy call is not the time to find out that your BLS partner is not capable of performing their BLS skills and I owe it to my patients to make sure they are not put on the recieving end of that particular situation. There is nothing "god like" about any of this in my books. This is not however a two way street. I have already prooved myself with years experience and my ACP certification and the suggestion of proving I know the adverse effects of every med I push is absurd. 90% or better of all the basics could probably not tell me what I can give for drugs let alone any of the indications, contraindication, adverse effects or dosages. Any basic that says they can walk onto an ALS truck with a partner they have never met before and have nothing to prove is wrong, or their partner doesn't care enough to investigate. I however care about my livelyhood and my certification and I'm not going to let anybody else ruin that. As a side note, I'm talking about basics that have completed a year long education with proper hospital and ambulance preceptorship, not the 140hr first aid course that is common in the states. So you can just imagine what I would think if in DJs shoes.

So... Around here our Intermediates are allowed to administer Narcan. But..... and there is a big but....they are only allowed to give it in a can't intubate can't ventilate situation (just like the paramedics) and they need to cantact medical control. I think we have a little different phylosophy around here because the only time we break out the narcan is if the patient is in imminant danger of dying and we have exausted all other treatment options.

Talking about public perception here, not what I personally believe. My personal beleif is that if you are really acting this way than you should not be representing this profession at all, be it driving, attending or in any other manner.

believe it or not it is possible to tube the esophagus more than once. Its all smooth muscle and alot bigger than the trachea. I have heard rumor that this is a technique but it has been never taught to me and I have never attempted it.

CSR, you have some serious issues. I don't even know where to start. I will say one thing though you are not representing yourself, your employer or the entire profession as a whole in a very good way if you are indeed acting like that. Rid is right, they won't remember you as a cop just as the loud mouther ambulance driver with a serious attitude problem.

That EMT on Oprah was so dissapointed with america because, and I quote "I save lives" and they didn't pay her enough.

PCP Salary 16.25 - 18.21 (35.476-39.763/yr) ICP Salary 17.03 - 19.36 (37.191-42.294/yr) ACP Salary 19.42 - 22.51 (42.419-49.169/yr) Keep in mind though that to attend PCP school it costs 10000$ and to attend ACP school costs 15000$. Also these wages are without overtime and we are also in the middle of re-negotiating our contract for an additional 9-21%.

Yeah, The idea is that we will be doing the EKG and completing the reperfusion checklist in the field and the doc will have already seen the EKG and will be waiting with needle in hand. I agree that is BLS providers want more stand alone skills than they should have more education. But that being said, It only takes a short time to learn how to do an IV. What if they were allowed to start an IV only when and where their ALS partner told them to and no other time at all?

Shane I'm going to disagree with you slightly here. We are just now implementing 12 leads for all levels. For the ACPs that will eventually mean pre-hospital thrombolytics. For the PCP or BLS the reason it is being given to them is to decrease the Door to drug time for patients axperience an acute STEMI. The 12 leads will be taken in the field by the BLS providers, they will continue with their BLS protocols for the call, the 12 lead will be faxed to the recieving facility via cell phone or land line depending on the location and the patient will recieve the thrombolitics faster. On annother note, I'm not against BLS providers having more skills. We recently had a debate here about PCPs starting IVs. A stand alone protocol for BLS starting IVs is a bad Idea in my mind because there is literally no reason for them to do it, however if the PCP has an ALS partner and they can help speed things up by starting the IV I am all for it. Its a simple skill really, just like administering most drugs and taking an EKG for example. My point is that the BLS provider is not deciding to do the skill on their own, its not for their own use and they are under direct supervision the whole time. The skills are easy, its making the decisions of when and why that are difficult and if it speeds up patient care and the BLS provider does not have to make those decisions themselves, I am all for it.

=D>

So by your reasoning we could send over an ambulance with my dog driving and my two year old nephew attending and people should be happy because an ambulance arrived in their time of need? Just because most of the general public isn't smart enough to tell the difference between an ALS provider and a BLS provider does not mean that we aren't. I know that an ALS truck will benifit the patient more than a BLS truck if for nothing else than for the fact that the average BLS truck only has 500hrs of schooling between everyone on board. Weather you work at macdonalds, in a business, in an office or out of your car, whan you start out you are the low person on the totem pole. Nobody walks in equal in skill or experience regardless of their level and people that think otherwise are just plain wrong.

We just adopted IN Versed into our protocols for seizing patients, I haven't had a chance to try it yet though. As for Narcan, our provincial medical director is not big on narcan being given any route. Except for unusual situations, we are only supposed to give narcan if we cant intubate the the patient and then we are only giving enough to bring back spontanious resps.

Thank god this is expression is never used where I am from. There is absolutely no evidence to back it up and I am beginning to suspect it is something that EMTs say to make themselves feel better about the low position they have on the totem pole.

I think that about sums it up, nice first post!

Unfornutaly, both statements are about as far from the truth as you can get.

My rule of thumb is; you can tell me whatever you want to as long as you have the best interests of the patient at heart. ie..If you see me about to push the wrong med, like AK said speak up loud and clear and quick. I will thank you for it. however, if say you see me about to push the wrong med, watch me push the wrong med and then bring it up back at the station in front of everybody and their dog, be prepared for me to rip of your head and $hit down your neck.

Try this link

I got that, i just don't see how it pertained to this discussion. Maybe i'm a little thick today. :wink:

What is going on with this site? I feel like i'm trying to look at a puzzle with holes in it!

I'm not quite sure what you mean by that. Nobody in their right mind would replace a paid service with volunteers, perhaps what you meant was that volunteer EMS agencys will always be a major threat to their patients.

If you would read what he said, IF you don't have the manpower to respond to calls than you are indeed placing peoples lives at risk and a new system should be implemented. That statement is 100% accurate. Easy, if not you than your town, village, or hovel will find the money to pay someone to do it. You listed your call volume and population below your post. You can't honestly tell me that 520 calls a year and serving some 29000 people cannot sustain a single ambulance.

?????????????? In my world a paragod is someone who thinks that they are gods gift to paramedicine DESPITE what everyone else thinks. I would like to point out that while you are correct that BLS comes before ALS that despite all the fancy book learnin' most medics are infinitly more capable of performing BLS assesments and skills than your average BLS provider, given the added experience and schooling. Believe it or not we can do both. P.S. I am bald and have a star of life tatoo. (both before I was ALS) I also am perfectly willing to tell a idiot they are being a idiot weather they are BLS, ALS, nurse or doc. Some might call it a paragod syndrome but again I did it when I was BLS too. If you don't tell stupid people they are being stupid how will they ever know they are stupid? They may be too stupid to figure it out on their own.

You are absolutely correct dust. As long as everybody is being self centered. "I" made 60000 dollars last year. "I" only work 42 hours a week. "I" am not on call when at home. "I" have excellent benifits. and "I" have an excellent pension. If you are going to be self centered make sure you actually have something to be self centered about.

So really, your service isn't that valuable if you don't have enough volunteers to respond to calls. Like dust said, if there was no-one jumping in a truck today for free they would find a way to pay for someone to do it tomorrow. Again, welcome.

First off, welcome. However, your Volunteer is not valuable. It is the only thing that is keeping your area from having a full-time paid EMS crew. It may take the paid guys 10 minutes to arrive on scene but picture this.... The paid guys are in your station.... Or you are one of the paid guys.... Nobody is going to offer to pay for a service that they already get for free.