Nate

We had a similar setup, and it showed many that being an EMT (of any level) is more then just dropping off a package. Many believe we are FedEx with human cargo, and that is one of the biggest problems with education in EMS. The colleges are restricted by number of semesters, the private schools are offering a faster turn out then the colleges, and some where between the two a good chunk of IMPORTANT information gets left out. I'll be the first one to admit I don't know every single thing about medicine or pre-hospital care, but I do know that it is VERY important for everyone on that truck to understand why we do what we do, what the effects are, what the benefits are, and the risks. Even more important is knowing that even though we aren't seeing the effects of procedures or drugs like Lasix right then and there, we are setting the patient up for a faster discharge because we STARTED treatment. I strongly suggest anyone who has never had to do a shift with a doctor to go and ask (most will let you) to hang out for a day and be quizzed, see what happens after we leave. The multiple blood draws, the effects of the medications, the stuff that often gets over looked during hospital clinicals because more and more EMT-Basic students (and other levels) are being used as "free labor" by ER staffs.

No, there is no point in having someone who can do the skill but doesn't understand the principle of why the skill is needed, when it is needed and when it isn't, etc. I voted for the removal of the EMT-Basic level. I've been pushing for Texas to stop EMT-Basic classes and start making the EMT-I the entry level (and up them to I99). From the aspect of 911, I would rather have an EMT-I then an EMT-B. The EMT-I can intubate and start IV's, which can be a big help when the calls get rough. There is a reason why a lot of services in the Houston area who can't hire enough paramedics are only hiring EMT-I's.

Hmm, got me wondering if something else was in that drip. :?

I've never had a problem with, the four doctors I've asked said they have never had an issue with it.

We could just label a saline flush as Narcan and let them think they are pushing something important.

:roll: <~~~Do you see the concern in my face? Dude I could really careless what you do or don't do, I just wanted to aggravate you because the enjoyment is so much more when I can irritate you and then watch Dustdevil pounce all over you.

Eh, I guess I can allow you to breath.

I know that SZ can be caused by just about anything, but has anyone ever seen someone have multipule sz from propofol?

I don't think you should be able to breath, but that is just my view.

Do we really need to have these constant talks of BLS doing ALS skills? If someone really wants to do that skill, then they need to go and become the level of certification. Like everyone says, there is more to an IV then just sticking it in someone. A little 0.9% NaCl can hurt a patient if you give it to the wrong patient.

Those courses that I listed were pretty much a mirror of most of the nursing programs here in Texas. I don't know where your looking at medical school, but you need a hell of a lot more then that to get a basic biology degree. I only listed 16 classes above, so if you took four a semester for four semesters (2 years) you would only be at two years. Combine that with a 2 year paramedic certification program and you have four years. If they can't finish a degree at 12 to 15 hours a semester then maybe we should reconsider if we really want them in here. We CANNOT continue to hold people's hands and make it "easy" for them to get through the paramedic program. When more of a shortage starts happening for paramedics, the pay will go up, and we will start attracting better people to the programs. [web:f89be90dc1]http://www.stthom.edu/academics/schools/artssciences/biology/programs/major.html[/web:f89be90dc1] Hard to attract them to a graduate level education? If the pay, rewards, and benefits were there, I don't think so. However, we haven't really created a "need" for graduate level paramedics. We are kind of in a rut. We are the pre-hospital providers, and we will always be limited by what we can do, and how far up in medicine we can move. It would take the acceptance of paramedics into the ER as front line providers and the doctor's right hand man/woman before we could start to think about a graduate level provider. We are there, almost every community college down here in the south has at least the EMT-B, if not the EMT-P program. We just need to advance it out of the community colleges and into the four year universities, which is a tough battle because most don't see a market for the program. There would be more of a chance if the state was pushed into helping the cause.

I agree.

Shut you paragod. <~~~Runs away.

No I'm not kidding, and there is no argument out there to suggest any reason why we shouldn't move that way. There are however issues with funding (I'll give you that one). I have yet to actually meet a decent paramedic who thought that paramedics weren't needed for 911 services. However, like Jake said, that is another topic. Back on topic...

You once pointed out that we should move towards what nursing does. Where you go in off the street as a nobody and come out a nurse (paramedic in our case). I agree with you on that, so I do not feel that preference should be given to those currently involved in the field. We could be passing up much better students. I think that prerequisites are important, some that MUST be added are as follows: [*]Biology [*]A&P [*]Chemistry [*]Organic Chemistry [*]Medical Terminology [*]Medical Law Class [*]English [*]At least Trig, there is so much more to math then just numbers [*]Physics [*]Psychology [*]Sociology [*]Child/Human Development Psychology [*]Speech (because there is nothing worse then not knowing how to speak properly [*]Economics (you need to know how to manage money, epically if your going to be in upper management) [*]Government, one must know how governments work [*]History is important because to many people don't grasp why history is important and is needed for any degree Paramedic should be the crowning "jewel" of the education, not the only education. I do not believe that a Fine Arts background is nearly as good as a biology major. I would suggest that the preference be given based upon academic performance in the fields of interest similar to what is currently done. One would to be developed around the paramedic field, but I think that aptitude testing is needed because it gives you a way to "remove" those who you need to remove. They also show a level of dedication, as those who REALLY want it will study to do well on that test, as opposed to blowing it off. If we are starting from the ground up, then this isn't important as these skills should be taught to them. If they are coming off the streets as an EMT-B or EMT-I, then we run into the issue of "I was never taught that." How can we hold it against them what another school/service failed to honestly teach them? This is important, as you know EMS doesn't have the most stable people working in it. Those ego hungry ass-hats need to be weeded out to prevent further damage to the industry. Also, those who are weak, or would be effected emotionally easily should be removed. There is a difference between caring and being weak.

Amen brother. =D>

I don't think they do, otherwise a quick search on google would have provided enough information for why the drug shouldn't be used by an EMT-I alone. I posted because I felt that someone who was an EMT-I should be allowed to push the drug if they were around an EMT-P because the extra set of hands could be helpful. [web:57f64fe92d]http://www.sciencemadesimple.com/sky_blue.html[/web:57f64fe92d] I'm Rick James!

If I'm not getting paid, then I'll be sleeping in my own bed. I tested for a service that during orientation told us they were switching to unpaid nights unless we ran calls. I got up and left.

:shock: No, I think of how I'm going to spend the money I just made for working the shift. :wink:

I wouldn't suggest giving it alone, as there are side effects and you never know what is going to happen. Granted the same thing could be said if you don't give it. Hmm, another reason why we should just require a paramedic on every truck (now there is a good idea). Seeing as how EMT-I's are taught how to push drugs properly, I see no reason in allowing an EMT-I to push the drug if the paramedic is sitting there with them. If I'm at the head of the patient, the EMT-I is at the side, no reason why they can't be allowed legally to push it. If something was to go wrong I'm there to fix it. Then again that could be said about a lot of drugs as well. The point is that you don't slam 2mg of Narcan home. You should titrated it to respiration's/effect, to many people think they have to slam 4mg of Narcan and bring them off their "high." Sorry, but I don't like getting my ass kicked, I think I'll keep it so respiration's are good, perfusion is good, and they are semi there. The ER can have the fun of waking the beast up. I have a question. Do people actually think before they post questions?

I think I'm going to need a rescue boat with all of the crying going on. Freaking flood waters are getting high.

If people freak out this much about a TV commercial, I hate to see what they would do if they ever saw something that was actually serious in real life. Maybe it is good that these people aren't in any position of authority...over reacting is how wars get started.

Most of the things that were quoted should be known by the average EMT-Basic. My EMT's don't argue with me, and from what I've seen with their interaction with other paramedics, they don't argue with them etiher. Point being, you don't argue with the person who is of a higher patch unless you see them about to do something very wrong (such as intubate a person who is talking to you and has nothing really wrong with them other then they are really freaking annoying). They will ask questions such as what does that do, or would this be the next step on patients who are out of it. If the patient is A&O x 4, then they will usually hold those questions until after the call because they don't want the patient to think that only one person on the truck knows what they are doing. With that being said, damn well near all of my EMT's that I run with know what every single drug in that bag does, what it is used for, and what is going to be needed in association with the drug. Most of my EMT's know what I'm about to do, so when I'm going to give Lasix all they ask is "what size syringe would you like?" The got that because when they showed up on day one they went through the ambulance, they did that on day two, three, four, etc. until they knew every single object on that ambulance and it's use. When a rookie comes in, I show them my squad, my bags, and explain anything they aren't clear about. I don't expect them to know it the first time out, but by the sixth time they should have a pretty good understanding. I'm damn proud of them, and I'll stand behind every last one of my crews. I believe in them, and would put any of them against any other EMT on this site. Call it cocky, I call it a good crew. They like to be the best, they know they are the best, and most of them are headed for bigger better things (nursing, paramedic, other four year degree fields). They didn't get this way simply because I told them this or that, they are this way because we communicate, we talk things over, and most importantly, THEY WANT TO BE THE BEST. My belief is this; we are the same people outside of EMS, we are the same people in the station, the only difference between you and I is the fact that I'm the highest ranked person on the ambulance. Outside of that call, we are the same. So I treat them with respect, they treat me with respect, and we provide great patient care. The end result of the crews I work with is: [*]Fewer work related accidents [*]Fewer mistakes made in regards to patient care [*]Incrased understanding of the EMT-B level [*]Good base for advancement to other levels [*]Awesome work environment [*]Less stress, everyone has a good time [*]The formation of a working relationship that allows crews to come together as a district/station/service and handle just about anything What those of you who have issues need to do is get off your fat, lazy butt and start freaking talking to your paramedics/EMTs and opening up those channels for communications. I'll be the first one to say my service has it's downfalls too, but after hitting rock bottom a few of us paramedics and EMTs said screw this, we can do better then this. So in the end we have what we have, but that isn't possible if we don't trust each other, talk to each other, and respect each other. Grow the hell up or go find another career path to follow, this field is to damn important to have a bunch of babies who can't get along.

We have Nubain, it is okay. I'm not a big fan of it.

OMG, now I know why I don't post a lot over here anymore.