paramedicmike

I've always preferred:

Unfortunately, that's part of the game that is EMS testing. New updates in care, new research findings, new technologies make their appearance and it can be a while for Registry and especially state tests to update their questions. Sometimes one organization makes their changes faster than others. This is also part of the game of taking care of patients. New research teaches one practice. Local practice guidelines dictate another practice. Which do you follow? The new recommended way? Or the old guideline way? Over-thinking can be a problem if you let it paralyze you on scene with a sick patient. Sometimes you need to make a decision and run with it. The trick is to make sure you have a reasoned decision making process and can defend those decisions after the fact with either solid science or, depending on the situation and legal issues, your local treatment guidelines. Your learning will never stop. Well, your learning should never stop. You're going to need to keep up with trends and changes to be successful. Congrats on passing your exams. Now the learning, and fun, really begins.

It's about time you showed back up. Where've you been? Hope you're well.

This addresses a much larger issue that's tangential to this particular discussion but is still important. There is a place for IO access. It is not appropriate for every patient or even most patients. If there is a skill issue and providers are choosing to place an IO in place of an IV simply because their IV placement skills are deficient then there is a larger systemic and educational problem that needs to be addressed. I believe the original claim made by the provider in the good Captain's OP isn't as accurate as she claimed and has been addressed in follow up discussion.

Add me to the list of people who disagrees. Most employers I've encountered in the several states in which I've either been involved in, or had contact with, local EMS have shared the practice ERDoc outlines. Specifically, if you have a card and a pulse you're hired. At the same time, because there's 40 people lined up waiting for that job one can be fired on a whim. But there's always another transport company willing to hire you. Even larger services running 911 don't always care if you have no experience. Municipal services run you through their academy. At the very least they have their own field training program for new hires regardless of their experience levels. Leaving the paid/volly argument aside for just a moment, volly services can be exceptionally variable. I would be really hard pressed to call 911 for an ambulance in the area I'm living now because all the responses are a volly BLS response. All the departments are fire departments and a condition of membership is you have to run on the ambulance. This creates a situation where there are a bunch of EMTs who don't want to be EMTs... they have to be to run on the engine. I see these guys every day when they drop people off in the ER. Their care reflects their apathy for being on the ambulance. Even volly experience isn't what it's cracked up to be. I'm inclined to agree with Ruff on this one. Depending on the location of the OP there must be something going on with either the résumé or application process. Or there's a whole lot more going on that the OP is choosing not to share.

Congrats. Now the learning begins.

I'm not trying to make a huge deal out of it, either, Mike. You asked for thoughts. My thoughts included the idea that 80% of all statistics are made up on the spot 93.4% of the time. As 75% seemed awfully high my first impulse was to ask about the veracity of the numbers. Until the numbers are quantified and/or verified a little more thoroughly it's really difficult to identify any kind of problem or systemic inefficiency.

It's been years since I worked with the person in question. There was backlash from the medical director but I don't know how far that went. I couldn't even tell you if this person is still working as a medic or not. Sometimes, you just need to distance yourself from events, people and places. Sometimes, there just isn't enough distance.

Seventy five percent seems really high. You said you had no reason to doubt her numbers but I'm still skeptical. Does she have solid data to support the claim?

Depends on the program. That would be something to further research when you start thinking about colleges.

This blows. Condolences to family, friends and coworkers of those who died.

You'll need different theme songs depending on your mood. Some days you could walk in with the Darth Vader theme. Other days you could walk in with the Andy Griffith theme. Or Ride of the Valkyries! Yeah! That's the ticket! Yeah!

I used to work with a woman who would intubate opiate overdoses and then slam 2mg of narcan. The patient would wake up pissed, confused and gagging because of the tube down their throat. As the patient was typically on the stretcher at this point and appropriately restrained for transport s/he couldn't get up which would just incite more anger. Yeah. That did not go over well. Not with me. Not with the patient. Not with the boss. And most importantly not with the medical director.

PA school is a graduate level program usually lasting 24-27 months. The first 9-12 months are didactic work. The rest is clinical. There are programs out there that will combine undergraduate work with the graduate program and make it a five year straight shot. This works out so that what would be your normal senior year in college is your first year of PA school. Your second senior year would be the clinical year. You graduate in five years of straight schooling with a master's degree. During my first year of school I dropped to part time and worked one 12 hour shift a week. Honestly? Given the intensity of my program even that one shift a week was too much and I wound up quitting that about eight months into it.

I am a PA. I'll be happy to answer any questions you may have. Let me know. Edit: It's not "physician's" assistant. No apostrophe. I don't belong to a physician. Assigning possession like you did is a common mistake. Most people do it because they don't know better. However, many PAs out there will really take offense at this mistake. Just so you know and are aware. That being said, in this case I am not offended and am still happy to answer any questions you might have.

The line guys may be fine with it. But it's management you need approval from in order to actually ride. That'll be the catch. And management is looking at insurance and liability and legal concerns. Doesn't hurt to ask. Be ready to be told not yet. If they tell you yes, and you can ride, coffee and donuts would be a welcome treat. Honestly, though, health conscious treats would be better. Use your discretion.

Welcome.

That explains why your class was so long. Your experience is not typical for EMT training.

This. +1000.

Some courses, such as Mari's, are longer. However, for EMT-B, that is rare. Most courses are of the two week accelerated course to three month standard length course variety. Some classes may be four months if they stretch it. Why are you under the impression that EMT-B is a two quarter sequence? When you say you're having trouble getting yourself going what do you mean? Like depression kind of motivational issues? Laziness? Stayed up too late drinking beer and playing video games? Shift work doldrums? Something else? What's up? Figuring this out now before getting into EMS, a profession known to have moments of intense emotional stress, might be a good idea so that you've got some good coping mechanisms in place before making the switch. Let us know. We may be able to help.

Agreed. That's not an accelerated course. That's a normal time for an EMT class. So is it just your job schedule conflicting with class? Or are you have some time management struggles? Or are you really just conflicted because you're enjoying working for UPS more than you thought you would and are second guessing your motivation to be an EMT?

Welcome.

I think that open box design is going to be a little drafty in the winter, 'Kat. You guys do get pretty cold up there from time to time.

Just how accelerated is this EMT course if you're still going to be taking it when the Holidays roll around?

Every ground based ambulance I've worked in has been diesel. The only gas powered ambulance I've ever encountered was engulfed in flames on the side of the road as the diesel powered ambulance I was in drove by.