Nate

They didn't ask me until I went to upgrade from basic to paramedic.

School background checks were done after I was done. The state does their own, I never cited any criminal history on mine, but got in trouble for trespassing as a kid and the state asked me about it. Nothing major, they just wanted to know. I didn't feel like it should have been on there because I wasn't 18 when it happened. They said I was right, they were just wondering what it was about.

I had to submit to a background check and so did the rest of my paramedic class before we could get our license.

What I believe is wrong with EMS and what I want to change about EMS are things that a lot of people aren't going to be happy with. In fact, the only people that are going to like this are those whom are willing to put the time and effort into it and take pride in what they do. Three man trucks, that isn't a big deal. There are a lot of services down here in Houston that run BLS/ALS/MICU trucks and still use a Squad with another paramedic on it to help out when needed since not every call would warrant a three man crew.

When I become a doctor I plan on bringing EMS locally up to speed. There are a lot of ideas that I have that I'd like to test. Personally, I would like to do a lot of research on the ambulances as far as pre-hospital care and the use of some drugs to speed up the time spent in the ER. I know I'll meet a lot of people along the way that won't be happy with my ideas, but that is anywhere. I'm looking to do for EMS what out patient day surgery did for the hospital business. There are a lot of things that I believe paramedics are capable off. If I can't get others to follow; I'll just lead the most advanced service in the US and set the bar higher. First thing, I believe that three man ambulances will be what it takes to put most of my ideas into place and have them work well.

What happens when the BP machine goes dead or hay-wire? Hope they remember how to take one by hand.

The Texas version, yes...because I don't feel like our current requirements for LP are enough. I really feel that there should be more science and math involved and that it should carry a four year degree.

Because if you only want to stop at paramedic, then LP is as high as you can go education wise. I think that is why we see so many go onto nursing and medical school; because they see that EMS in Texas doesn't pay. There are very few employeers that pay/see a difference between EMT-P and LP.

Now your putting words into my mouth. If I wasn't going to medical school then I'd get the LP. But since I'm going to medical school (or at least I hope to get in) and it since I'm short on time (time is money) it doesn't make sense for me to back track for a semester of school.

Wow that is hard to read on the brick background. I'm saying that taking the courses to earn an AAS degree that won't get me any further in EMS isn't worth doing when I can take the same classes and get the credit I need to further my education on into medical school. The classes are needed, I just see that it is better in my case to pick the four year degree over the two year degree. With this route I have everything the state requires for the LP, but I just won't have the patch/degree which is no skin off my back. Now if I'm not mistaken I can take the classes from the university, find a college that offers the AAS degree and will let me test out of the basic class and get the LP. Dang, I never realized how f*cked up Texas was until this debate.

There are services that perform pericardialcentesis around here; and while a chest tube wouldn't be that bad; it is the level of infection that would worry me. Also, our transport times are with in 10 minutes, I think some of the rural services around here could benefit from this though.

Because the paramedic degree isn't going to make me any better of a doctor when I can do just as much with the certification, and I will have be taking the same classes anyways. Don't jump my butt because Texas won't allow a science class from one college to transfer to another university. If the LP would have helped me in some way then I would have gotten it, but it won't. (Other then to take two of the classes twice.) I like you, support the idea of a four year degree plan; but that is going to make more people offering the degree and more employeers requiring the degree.

Come work with me at my service, when ever I get on the truck I have the people on the BLS/ALS truck to work with. One drives, one helps me in the back. All crews in my station know the way I want things, and know their own assesment is expected and valued. I do honestly believe that auto BP's are valuable, and will say that the ones found in most ICU's that are tied into the monitor system are pretty close. However; lets face it, your not going to find flight grade machines on every ambulance. I'd love to have one of those compact HP monitors that some of the flight services around here use, but it wouldn't hold up the abuse a monitor on a truck is subjected to on a daily basis.

I worked a part-time gig with a service where almost every basic seemed to have either stolen an old BP machine, bought some sort of BP machine from Walgreens or CVS, or had some reason why they couldn't take one for me when we were in the heat of things. I think the automated ones on the LP12's suck donkey balls. They are so freaking inaccurate, and it really drives me up the wall when people turn the LP12 on just to get a pulse ox and a BP becasue they are to lazy to take a pulse by hand or listen for a BP. So I think they are bad because it makes medics freaking lazy. I'll believe my partner or my own reading over a machine any day.

I know our local flight service Memorial Hermann's LifeFlight does them; but I'd be worried about letting PHI's SkyCrap touch my patient.

Haha, that is true...they can't even pick a name to call themselves. But it seems that an LP only needs an AAS degree plus EMT-P certification with all classes being taken through a college. My basic I earned in high school through a joint program with Cypress Creek EMS. It was a year long class that taught us not only how to be a basic, but how the body reacts in emergencies (on the basic level), as well as how to function with a paramedic. Yet I was told by three different colleges that I would have to retake the class because it wasn't enough to challenge the test. (WTF?) Also, the biology that I needed for the university wouldn't transfer from the community college I was at, so there was no reason for me to retake biology and A&P to become an LP and then to satisfy my biology/pre-med degree. The LP degree is a joke in Texas.

To be honest, I don't think we have enough well trained medics in our area for services to start adopting this procedure.

Does me no good, I can do the same thing, make the same wage, and it would set me back a semester to go back and take the EMS classes. (One of which is the EMT-B since I took mine in high school.) Plus I like the medical directors patch (and pay) a lot better. Still only need a two year degree with a science background. Had a friend who went through EMT-P with me and he just sent in his paperwork. He had the regular requirements for a AAS degree + his EMT-B, EMT-I, and EMT-P classes as college credit.

I wouldn't call it a step above EMT-P. Remember you use to be able to get it with a two year degree in art history if that is what you had. Now you just need a two year degree in science.

What...I haven't heard/seen these since EMT-Basic school. We have some on our truck, but that is because no one has taken them off yet. I haven't seen them used in a long time.

Don't get me wrong, they are funny to laugh at; but there are some that need to be delt with because they won't know when to stop because to them...they have no limits. There are however; some really good paramedics with that kind of complex.

I agree 100%, although I'm worried that some on here might not have the sense of humor to both understand and laugh at the "para-god" syndrome.

I mean when it is parked.

The two services that I work at require you to confirm flat line in defib view as well as Leads I-III since we only have three leads. One of them requires you to print strips in Leads I-III for all transports that a monitor is used, with print outs every 15 to 30 minutes depending on how long the transport to the ER is, with a min. of two sets of strips for any transport under 10 minutes.

I voted for treating the patient in the unit. How I do things: I carry in our jump bag, front line drugs, and monitor on every patient. Once inside I have everything I need to work a full code for a few minutes until FD can arrive to help lift/load and with CPR. Typically if they are stable and not in cardiac arrest, and are stable like how you have presented us with; I would prefer to load the patient after first round of vitals and assesment. Why work in the truck? I don't ever feel safe on a scene unless I'm in my truck. I prefer to work in my truck, I know that sounds odd to some, and normal to others, but that is just how I am. I was always instructed to "do what is best for the patient" and that the ambulance is safer than the scene; but if for some reason it would be better to work them there first, then by all means work them on the scene. Scene vs. Truck I think it is more preference. I have worked with people who prefer to remain on the scene in the house and start their IV, get a strip on a stable patient, talk for a while; that is just how they are. Others I know like to get in the truck and spend 10 minutes doing everything; while others prefer to just load and go and do everything in route. I think it is more style then anything else.