paramedicmike

To borrow a line from Dust, if that's how it goes in your area then your area sucks. Remind me not to get sick if I visit. What bothers me more is that you just seem to throw up your hands and accept such mediocrity. Why aren't you working to change this? Why are you so resistant to the idea of change? Especially when it can be an improvement to what already exists? Dust and Rid are right on with their assessments. I also think they're right on with their ideas for change. And either way you look at it, change in the form of increased education and guidelines (as opposed to strict 'follow these protocols or else') is on it's way. It may take some time. But we should be getting used to the idea. -be safe.

That's great you know what "incompetent" looks like. Too bad you don't know what the spell check looks like. Education might not completely remove incompetence. But by having increased educational requirements the rate of acceptance into educational programs of people who don't need to be doing this job will decrease dramatically. With that you'll see not only more rounded providers but providers who are dedicated to learning, providing care at the highest possible level and are skilled in their job. Funny. It seems that the people who argue most against education are the ones who are afraid that they'll lose their jobs if educational standards are implemented. Or they're ones who wouldn't have gotten the job to begin with. College/university education is not bad. And if you're afraid of it you should reconsider where you are and where you're headed. -be safe.

How the hell did I miss this? I think he's just going to add yet another service/theater ribbon to his uniform. Good luck, Bro. Be safe. If you need *anything*, or your unit needs *anything* (e.g. mail, care packages, sunscreen whatever) let us know. I'm quite sure we could put together quite a bit for you and your unit...just gotta give us an address once you get it. God speed! -be safe.

Go back and watch some of those episodes of "Emergency" again. Some of your observations about what happened in the show aren't as astute as they could be. Have you done any of your own research on this topic? Like on the origins of battlefield medical care and how it evolved into what we have today? Like on some of the influential papers written on the topic (something about death and disability being a neglected disease...that's a hint)? Less than five minutes on Google turned up several screens worth of information. Or are you looking for a first hand perspective from some of the vets who lived and worked in this time? I understand you're still a student. However, having done some research will help you when you come to the table with questions. Try that first and then we can help with other questions that may either be left unanswered by or as a result of your research. Good luck! -be safe.

You sure you're from Weymouth? You can't even spell your Commonwealth's name correctly! All that with a spell check feature conveniently provided by admin. As for getting the job, it depends on the company now. Did they give you a date by which you should hear something? -be safe.

Do a search on this site about why the NAEMT is so worthless and you will find more info than you probably care to read. If nothing else, though, you'll get the answer to your question. Good luck. -be safe.

What do you think? Thought I'd stir the pot a little on this Monday. http://www.usatoday.com/news/health/2006-0...aramedics_x.htm -be safe.

Looking back at my initial post questioning infection rates, I didn't intend for it to sound like I was badmouthing RNs. I can see how it would come across that way. I hope, despite my poor language skills at this late hour, noone took it that way. I understand that hospitals have policies regarding certain things. I was just wondering if they had info I hadn't come across yet. Thanks for the info! -be safe.

The question of infection from prehospital IVs has come up a couple times in this thread. Are there numbers to support an increased infection rate from prehospital IVs at your hospitals? Or is it simply a perceived threat? If there are, in fact, increased numbers of infection that can be definitively attributed to field start IVs, is anything being done to address this with local providers in an effort to decrease the numbers? Or is it simply something else for the RNs to bitch about? It would seem that something as serious as this should be addressed sooner rather than later. I realize that, given the environment in which many of our patients are found, infection is a real concern. But if it's that big a deal that you're seeing legitimate problems I'd be curious to hear what is being done to change infection control methods in the field. -be safe.

So if someone comes into a service and I have to be hard on him because he's an idiot that automatically makes me a paragod? Not trying to be argumentative. I'll also disagree with the notion that they're not idiots. Any new person is an idiot until proven otherwise. Just because they've gone through two years of college and managed to BS their way through an interview doesn't mean anything other than they can successfully BS their way through an interview. I've done six years of college and some people still say I'm an idiot. -be safe.

If the person in question, knows what s/he is doing, acts appropriately, isn't an arrogant know it all, doesn't cop an attitude, is confident in his/her skills, asks appropriate questions, admits to not knowing something then asks so as not to have to revist the issue later then fine. If the person in question has one or none of the above qualities/traits then they deserve everything they get. Yes, be fair. Don't pick on the person just to pick. Don't get personal and don't attack a person on that level. But it is our responsibility as the senior staff to make sure the newbie is up to snuff. This isn't a game and it's not a hobby. We have just enough in our toybox to cause some serious damage (if we don't wind up killing someone). And if that person fvcks up then not only is it his/her tail on the line, but the partner and the organization. It's our job to get this person into shape if s/he's not there already. I've seen it before. In fact, it's going on right now at my full time gig. People want to hand hold a new hire who's a pathological liar and an extremely bad medic. Do you want someone like this showing up to take care of you or your family? I live in my local and damned if I'm going to let this bonehead take care of me. Be fair but be hard if needed. Weed them out. The EMT mills don't do anything to prepare people. That's up to us. And if people don't like it, well, then don't work in the industry. -be safe.

Techmedic: An update on some of the info you posted. I just received my Maine license in the mail. The whole process took about 5 months (no fault of Maine EMS, though. Some of the paperwork needed to go through my current office of EMS and they're just incompetent). It did cost me $65 for the paperwork shuffle and application fees and blah blah blah. Other than that it was fairly painless. Massachusetts has some goofy thing re: practicals. It has something to do based on where you took your initial test. If there were practicals involved and your state of origin signs off on it I don't think you need to do the practicals regardless of how long ago you took them. At least I didn't have to take them. And the computer based exam wasn't too bad. My card doesn't say "license" on it, though...only "certification number..." What did I miss? I went for Maine as I applied for a few jobs up there and could see myself living there. I did the Mass process only because of a girl. The subsequent search for employment in Mass made me realize that the Commonwealth of Mass is really f**ked up when it comes to EMS. As such, I really have no desire to work there. Just some observations. -be safe.

PA is the same. NR is the state's paramedic exam. Pass that and you don't need to maintain it. However, PA is goofy in the sense that once you're certified it's a lifetime certification. To stay active you need 18 hours of con-ed a year and the sign off from your medical command physician. If you decide you want to take a year or 12 off all you have to do to come back is take 18 hours of con-ed, get hired and convince the MCP to sign off on you working. Maryland requires NR for initial certification then passing the state protocol test for state licensure. So long as you maintain your NR you maintain your state license (yes, MD licenses their paramedics. Maine does, too.) I keep my NR for a couple reasons. I'm not staying in one place yet. It has made some reciprocity issues easier (not much...but a little). And I worked too damn hard to just let it lapse. -be safe.

So what do people think of this as a potential solution? Not that I think it'll get very far but just for S&G... Maryland requires NR for both their I and P level providers. Once you've successfully completed the test at your respective level, you take a state test on the statewide protocols. Pass that and you're good to practice anywhere in the state. To continue working you maintain your registry cert and complete protocol updates as they are made. I realize that not all states operate on a statewide protocol system. (I think they should but that's another issue altogether.) Would a program like this keep the states happy in that they still have their politically corrupt hands in the pot while maintaining some level national standards? Just thinking out loud...well...sort of. -be safe.

Well said Lithium (and Dust to have it recapped here). -be safe

This is a troll if ever I saw one. But I just can't help myself. There is no *need* for IVs started by BLS providers. Obtaining IV access is an ALS intervention requiring education, training and understanding beyond what's available through a BLS training course. It's not a skill. It's a procedure complete with risks, complications and is not needed on every patient. BLS education does not address or incorporate into the training (different from education) when an IV is needed, warranted, or required. It does nothing to address the thought process that goes behind the decision as to whether or not an IV will be initiated. If you, as a BLS provider are starting IVs for any reason, I hope your medical command doc has some kick a$$ malpractice insurance. No, BLS does not need IV access. If anything, your BLS system NEEDS access to a paramedic staffed ALS system to ensure proper and even (at times depending on the provider) intelligent patient care. And before you start going off about how we don't know what we're talking about, this topic has been addressed in several threads throughout the forums. Do a search, read the threads and then, and only then, come back with your questions. -be safe.

Is this for personal use while off duty for one of those "just in case" situations or do you actually have to provide your own bag/gear for work? If it's for those off duty, "just in case" scenarios you should probably check with the legal guys at your squad to see what you can and can't do off duty. Good Samaritan laws vary from state to state and it would suck for you to go out and spend all this money on items that you won't be able to (or shouldn't for personal legal protection) use. Congrats on passing. Now don't stop learning. Continue with school and your education. And double check with the legal types in your state to make sure all that nifty IV gear you want to buy/carry is in fact a good idea. -be safe.

I'm with AK. The first thing I'd do is call for help. The second first thing I'd do is cardiovert. -be safe.

I've heard stories of this happening before. It's never happened to me. But I've heard others describe similar events. I even talked with one guy who had a patient in his local with some sort of condition where, once CPR was started on him (usually by his family), he'd regain consciousness and be able to talk with you for the ride to the ER (where they were familiar with him, his condition and treatment) all while you were still doing compressions. The guy didn't remember the condition but had transported him twice when last we spoke. But back to the topic at hand. -be safe.

There was a thread on here not too long ago dealing with the hearing impaired and jobs in EMS. (I'm not saying you're hearing impaired. That was just the subject of the thread.) There was at least on other person who was either partially or completely deaf in one ear (I think. It's late. I'm tired.). Try a search to see what you can come up with. I'd help you out with it but as I just mentioned it's late, I'm tired, I have to get up early, and right now I'm just too damn lazy. Nothing personal. Good luck. -be safe.

I find it funny this comes from someone who described his occupation as "God". But seriously, I agree with what you've posted here as well as with your follow up . Most of this bugs even other paramedics, too. So don't think it's just a EMT perception of medics. -be safe.

Let's be fair to 7fissy here. Maybe he's just uneducated to the point that he can't read what Dust wrote. Maybe if we sent him back for a solid education he could wax a little more eloquently...or at least spell and use appropriate punctuation. 7: just because you don't like what Dust wrote doesn't mean you have to sound like a 12 year old talking tough. Intelligent conversation will get you much farther than simple grade school name calling. Got something to constructive to contribute? Have at it. Blowing smoke? Pardon us if we ignore you from now on. Dust has it down. The *ONLY* way to change this profession is education. There is no other way to do it. And if you don't want to hack it, please move on to something else. -be safe.

Care to explain what your research turned up that says this is legal? Care to explain why on earth you would switch to such a schedule knowing that you wouldn't be paid for certain periods of it. I suggest you confer with the Department of Labor and a reputable labor attorney (yes, they do have those in WV). You may want to do this on the sly, however, lest the powers that be decide to fire you for rocking the boat. -be safe.

Are you suggesting Philadelphia (properly shortened to Philly...only one "i")? As in Pennsylvania? As in the poster child for how NOT to run EMS? Avoid Philadelphia like the plague. Thinking of visiting? Don't get sick! Got sick anyway? Call a cab. You'd be better off. And I don't mean to beat a dead horse, but it's easier to spell check then post than it is to just post. Please use the spell check feature that admin has very considerately supplied for all. Thanks. Where in West by God are you? -be safe.

And because of these side effects I can't get behind BLS providing this intervention. Some of the complications that can arise out of this can lead to larger problems for the patient and the provider. It is not always a benign intervention. If it's going to be given it should be given by ALS with the appropriate tools to manage this patient once they start down the crapper. From a BLS standpoint, support ventilations/respirations with a BVM if needed and transport to the ED. But if you're going to give it, nasal is a great way to go. just MHO. -be safe.