Arizonaffcep

My old partner during medic class (an ALS truck, she was the medic) retold a story of when her partner at the time (both are 5 foot...at best) were on a dual medic truck out of a local hospital. One day, they were dispatched (on a dare) as "Paramidget 59."

"Would you believe..." -Get Smart

Wow...I'd give him only a 5...after the first bounce, he let his legs come apart...poor form...

As an addendum to my previous post, EMS is not a job for $. You do the job because you love the job. The money will come. It's not great...but survivable. Better in some areas than others.

I appreciate what appears to be an attack. Awsome. Just out of curiosity, are you saying that ff's can't be medical professionals? I know many people who would disagree with that...including myself. I don't believe going straight through is a good thing. I'm not saying you need to be an EMT on the streets for years...just enough to get your feet wet. How many medic students do you know of who have gone straight through, paid for the EMT class (in AZ around $800), paid for their medic class (in AZ around $4,500.00), stepped out onto the street, and said "it's not for me." What a waste of $5k+. Not to include the time and effort by everyone else involved with the training. It just makes for a more well-rounded medic, with a little bit of experience. In regards to interfacility vs 911 as a newbie, both are without question needed. But interfacility (in my opinion) is the best way to start for previously stated reasons. Ideally, getting on a truck where both are run is best, I would think. It creates a good mix. Besides, you can have some really good conversations with these people (not medically related, but a good conversation is still a good conversation).

If its not a HIPAA violation, its damned close. Best rule of thumb, ANY info that can PERSONALLY IDENTIFY, is HIPAA protected. If he gave the "approx" location, and a reporter was able to track down the victim, then he should be held libel for breach of HIPAA, as it DID identify her, name and/or medical conditions given OR NOT. Not good. What was his name...Green...<<mental note to write down to not hire....>>

Sounds interesting...in response to an earlier post in the thread about the class/program moving from UofA to a CC...it's a 2 year program, no? It probably is more logistically sound to have a 2 year program out of a CC and get an AA, rather than no degree as a 2 year program at a 4 year university. Just a guess. The previous pages are interesting (for the most part) about the whole team work thing. Just a little thought on that...If we aren't part of a team, how do we get the patient to the hospital? Can't do it as a team of 1. My personal experience with this is at my old fire department...my former captain and my EMT partner are two of my best friends. We had the understanding that I as the medic was in charge for medical things, but as a captain, had control over everything else. Let me tell you...the three of us were like a super well oiled machine. The more critical the patient, the more quiet we got (except for absolute necessary info, ie vitals, etc.). Everyone knew where and what they needed to do, and how to do it. The department is still a "podunk" little department with lots of problems, however I would have felt confident that if you pitted the three of us against ANY OTHER TEAM in EMS, we'd come out on top. It was amazingly good. By that same token, I've had partners that sucked and I had to tell them what and how to do everything. Much prefer the "team mentality."

It surprises me how many people are scared of this...Granted, $11k is a lot of money (although it's spread out over 5 yrs), and there is a large debate in Arizona's Dept. of Health Services EMS div. to decide if the state will go along with this or not. One of the things my wife and I have agreed upon with our program, is regardless of if the state mandates it or not, we will be accredited within 2 years (which is before the needed time frame).

The state of Arizona requires 110 hours minimum for an EMT-B class. This does not include clinical time (I believe it's 8-16 hours in the ED). Arizona has no requirement for ambulance ride time for a basic class.

I'd be curious to see his H&H values at the hospital...as another possibility is a slow hemothorax.

I agree...sounds like a spontanious pneumo. However, I would like to know more about the physical description of the Pt.

I once was on a medic truck at my old fire department and we were dual medic, with a medic student. The joke of the day was, "the patient'll have 6 large bore IVs and no vitals taken!" I would not say ALS is a different entity, but rather same sport, different levels. Kind of like minor leagues vs. majors...or American Soccer vs anyone else (hope that's not too offensive ). What is wrong with being able to do a good bls assessment as a bls provider? Why is it a bad thing? (as perceived by the above post) It's the foundation for a good ALS assessment. This is not to say it's impossible for a new basic to go straight to medic class and come out good. It's just been my experience that those that have a "better grasp" of the job and how to do it, have a higher chance of coming out "good."

This is true. However, typically, new grad nurses need to work on the "floor" for awhile, before they can transfer to a higher acutity unit, such as the ICU or the ED, or specialize even further with NP or nurse anesthetist. Even for flight...they must have, at least in Arizona, typically 2-3 years ICU/ED experience before they will even look at their resume. As far as doctors are concerned, once they graduate med school, they go into a residency program. Typically, the medical doctor has at least a 3 year residency, while the surgical doctor typically has a 5 year, plus a 1-2 year fellowship for their specialty. So...In essence they start out as interns (lowest on the ladder) and eventually become "attendings" after they graduate their residency and fellowship. How does that translate into paramedicine? As medics, once we graduate, our employer has us ride 3rd person for...how long? A week? A month? 6 months? Where as doctors are "3rd person" so to speak for at least 3 years, honing their craft, whereas by comparison, we are "thrown to the wolves." What I am getting at is not just being able to take a basic set of vitals. That's relatively easy. But it is a key part of being a basic AND a medic. This is also where you get to practice assessment skills and learn to build on them. Also, you get a chance to build up not only your confidence but also your interview skills to at least a basic understanding of how to do it. There are a couple of little "tricks" taught in medic class, but mostly it's a learning WHAT to ask, and when you get that new information, how to interpret it and WHAT it means to best treat the patient. It's always good (in my opinion) to go into a medic class with a certain amount of "tools" in your "toolbox." The class should enlarge the toolbox and expand on what is "carried" in it. On a similar strand of thought, this is why I always recommend that new basics and medics work interfacility for a little while, if given the choice, before going to 911. No, there isn't a lot of "action" on those calls. No there isn't usually a lot to do, because typically most of the work has been done. So, what does it give? An amazing learning expereince. For instance...how many different medical problems do you see on those patients? Besides, usually they are fairly compliant and usually patient people (no pun intended). How can an emt of any level benifit from this? First, start with assessment skills. Doesn't matter what or why they are being transported, if they will let you...do a WHOLE assessment on them! Look at everything. Touch everything (well...ok almost everything...don't get arrested ), ask everything. What's nice about this is that this gives the new basic/medic time to assciate different findings with the medical conditions. It also gives a chance to hone assessment skills, which is really the backbone of what we do. Without a good assessment skill base, you can't have a good basic/medic.

SNAFU=Situation Normal, All Fucked Up PARAMEDIC=Paranoid And Radically Arrogant Medical Emergency Dickhead In Charge AMFYOYO=Adios Mother Fucker, You're On Your Own!

One of my friends found this while we were in college...I just rediscovered it and thought I'd share it with everyone. Brings back memories... Dorm Life The inventor of dormitories . . . let's find him, make him pay for the travesties he's visited on America's youth, and force him to listen to Matchbox 20. Can't you see him designing these hellish stacks of humanity many years ago? From the sidewalk he raised his hands triumphantly and said, "It shall be like the projects with less violence and more marijuana!" He then took lumber and Elmer's Paste, as it is often called, to create these pet carrier sized rooms that we live in. You wanna know why people from the projects hardly ever go to college? It's because they don't want to leave their lush surroundings. The actual term dormitory is of course derived from the Latin term for sleep, which is appropriate because that is all you have space to do. You have to do it standing up in the bathroom sink but it can be done. The luckier students have space to scratch their *sses but the windows have to be open and their roommates have to be gone for the weekend. When you go home the closets even feel like a gymnasium, and you can romp around in the bathroom like a horny antelope. I can't imagine the kids who brought everything they own to the dorm. I brought like a condom and a sock. Next semester I hope to have a towel and the other sock. I also need a new condom. Forget having space to sleep. Who sleeps anyway? Nobody on my campus. I think it's a rule. This one kid tried but no one knows what happened to him. Let's just say his floormates never saw him awake again. I feel like I'm a member of the national insomnia coalition. 0ur agenda involves a lot of Frappacino and staring at the test pattern on tv. It's like this strange pseudo-vampire lifestyle. Did you know that if you stay up late enough they play the Tonight Show over again and it still isn't funny? No sleep really f*cks with your eating habits too. Every night at 2 in the morning you get as hungry as a Bosnian and you have to go to the vending machine to watch the one bagel spin in the carousel of salmonella. People have White Zombie playing until 5 AM, which to me really encompasses my mood at 5AM. I could be listening to Kenny G and it would seem hardcore at 5 in the morning. It doesn't matter because you still can't get an open clothes drier minutes before sunrise. There's like this one chick who’s always tying up an entire drier with like one pair of panties. I let it slide because it gives me an opportunity to watch hypnotically tumbling panties. The worst is when she turns out to be morbidly obese and you have to vomit in your laundry basket. Not that the dryers work anyway. I could fart on my laundry and get it drier than the converted toaster ovens that the university supplies. Dry jeans? Forget about it. I had to convert mine to a deep-sea wet suit. So what if you want to leave the dorm? Get ready for a chore. You'll need keys, ID, bag, books, a map, an umbrella, sun glasses, insulin, a snake bite kit, mace, a pack mule, and an Algonquin Indian translator (Miami students you know what that's all about). Then you have to go walking through the building kissing the *sses of all the dweebs you live with and holding the door for anyone in the same county. What's with the door holding policy? Like opening a door requires a spotter. If you've got arms, coordinated feet, or useful nub, open your own God damn door. No matter where you go you have to use these gerbil-on-a-wheel elevators. I could climb up the side of the building with a corpse tied to my johnson in less time than it takes for the door to close. Then you have to f*cking march for miles from your dorm which is conveniently placed on f*cking opposite side of the campus from any building that is f*cking remotely important. People on rollerblades I accept, people on bikes I have urges to clothesline but tolerate, but people on skateboards have a value just below medically retarded nazis. It must be explained to them that skateboards were cool when we were 11 and even then they weren't that cool. Where are you headed? Probably to get something to eat at the dining hall. The only dish they haven't f*cked up is Lucky Charms. I think the university supplies them with a blender and unlimited horse meat mixed with some retired circus animals. The key to making the menu fresh and exciting is the food coloring. The charming and buck-toothed lunch ladies proudly announce, "Yesterday we had chicken nuggets and today we present to you blue chicken chunks that are totally unrelated to the nugget dish we served you just yesterday. We are serious, they have nothing to do with each other. I stake my hair net on it. You can have extra blue in yours." And the ladies (who really seem to love livin in the exciting scooping career) refuse to serve more than what fits on a toothpick. You can't just ask for a large portion, you have to ask for "more than the offensive line could consume this semester." Then you get a second blue nugget. Remember how excited the potato bar got you the first week? Now the potato bar makes you homicidal. (What are bacon flavored bits made of?) Then you get to come home to your room. Mine is called a suite, which is a pretty cruel manipulation of the English language. I get to spend time with the closet case that the boarding office apparently found compatible with me. He's like Chewbacca's considerably less attractive estranged midget cousin. A wookie also has better control of the English language. My roommate is another rant all together. Most people get one of two kinds of roommates, the one who sharpens knives while he watches you sleep (mine), and the one who asks you what it's like to go outside (also mine). My suite mates next door live an intensely Rastafarian lifestyle. In an attempt to put Cheech and Chong to shame, their bong is a centerpiece of the room that they clean with wadded textbook pages. They smoke to Bob Marley at 3AM on Wednesday nights which is a little too hardcore but you have to love their dedication to the sport. End your dorm day by hopping in the shower. It's as big as a Tupperware container. It has 3 temperatures, f*cking hot, really f*cking hot, and nuclear. Whenever somebody flushes a toilet on the campus the temperature goes to skin removal levels and I go blind for a few minutes. I swear it is connected to every toilet. My brother flushed the toilet at home last week and I called him to tell him to be a little more considerate. The bathroom is as clean as any fast food restaurant urinal cake and after the average college student cleans the sh*tter with a bottle of Vodka it's as clean as any bus station. I've given up on cleaning the bathroom and I'm disinfecting myself. A quick spray down with Lysol Direct and my body is fresh and repellant to several bacteria. Bottom line. Turn up the music and try to get high off the fumes coming from under the bathroom door because they never share. The "best days of your life" will be over soon.

One of the BEST stories I've read in a while! AWSOME!

True, however which is better? A stand up 24 with BS calls, or having your wages garnished for a long time because someone misinterpreted what you said. Personally, I tend to educate the public one on one, and I am very careful what I say. And I ALWAYS end an "education" encounter with, "when in doubt, call 911." We are the ones who are trained to discern an emergency from a non-emergency, not the general public. Don't get me wrong, I hate transporting people with no complaint either. But it is better than the alternative. Besides, sometimes you can have a really good conversation with them. In Arizona, there is no real mechanism in place for people who call 911 infrequently for "nothing," however PD can be used to arrest those that are chronic abusers of the system.

Here's the one thing that I find interesting about the whole EMT straight to Medic thing...EMS is the only profession that I can think of, where one can go straight from graduating a basic class to a Medic class. I'll give you a for instance...in the fire service, once you graduate the academy, you must "prove" yourself (that you can complete certain basic skills) before they (most departments, most specifically, big departments) will allow the "probie" to move on to advanced things. Same with human development...you need to crawl before you can walk and run. When I teach a medic class, the one thing that gets to me the most is having to re-teach students how to take BASIC VS. Going into a medic class, this should be known. It's a BASIC skill. A medic course only adds tools to the tool box.

I absolutely disagree with the last sentence. I have been teaching EMS for several years, and precepting for more years that that, and there is a night and day difference between a person who goes to medic class straight from EMT class, vs. one that has at least a year under their belt. The new EMT turned medic has no foundation for their als skill set to build upon. This is why the program that my wife and I have set up will not even look at people without at LEAST a years worth of experience before enrollment.

On re-read, I think you're right. That's what happens when you still have goobers in your eyes from napping...

If it's what I think it is, in Arizona it's called a "Heart saver CT." This type of CT tracks the amount of calcium (not plaque) in the coronary arteries. There is a well established correlation between the amount of calcium vs. the amount of plaque build up in the vessels. The only thing I would be concerned with, is it's another CT that they would get while in the hospital. The first being a CT angio to R/O PE.

I would be careful about "educating" the public on what to call 911 for. Liability wise, it could be potentially devastating for you. Here's why: if you tell someone to call 911 for this and not to call 911 for that, the public doesn't/can't discern an emergency from a non-emergency. Where my concern lies is they may misconstrue what you say, and end up not calling 911 when they should, and God forbid, someone dies from it, they can go to a layer and say...ya this medic told us not to call 911, and a law suit is born.

I'm assuming that this is an electrical cardioversion, and not a chemical?

I love the job. It is a career that can be lived off of, however with as much time as you get off...it's very easy and potentially lucrative to have a second job (not necessarily FT).

Here is the guideline that EMS providers use in Southern Arizona. It's spelled out rather nicely...seems like one of the things we've done right! http://www.saems.net/Downloads/PatientRefusalTransportSO.pdf