AnthonyM83

I've heard that course of action so many times for so many different reasons since I started posting at EMTCity. I would quit every company in the county...and it's a big county! But I get what you're saying.

Estimated fatalities per 100,000 EMS workers is 12.7 Police is 14.2 and Firefighters is 16.5 National average is 5.0 (Refer Ann Emerg Med: Maguire, et al., 2002) I can't recall if another article I was reading was in reference to 2002 or 2006, but that year had 10 EMS workers die on-duty from GSWs. Obviously, there were more that were shot but survived. My guess is that certain areas account for large percentages of these incidents that other areas don't even know about.

Though I'd turn the other thread around. What do you like about the job? More than just "getting to help". -Cracking up in the ambulance with your partner to the point you can't answer the radio without laughing. -When the ER doc, lets you participate with a procedure. -Dry runs in the middle of the night (aka no transport)

A lot of the job isn't that great, but I try to find ways to get something out of it. An interfacility transfer is a chance to read medical charts, read about their surgery blow by blow, practice assessments and vital signs, or get a good story from another time out of them. Things I don't particularly like though: -Partners who hate the job and have no interest in medicine. Just makes the shift a chore. -FD acting in demeaning manner toward ambulance crews or putting patients at risk due to laziness. -Immaturity. Don't mean acting youthful/silly, rather people lying, doing things only to appeal to management, narcing on crews for non-dangerous stuff (who even taught them to do this?), forcing others to comply to one's personal style, aggressive/demeaning behavior (gave that up in HS). Guess it's part of having a young workforce?... though didn't see ANY of that in any of my old jobs including college aged jobs. -911 Calls for self-described non-emergency chronic problems (which hasn't recently become worse) for 3AM transport to ER (where we might be waiting until 7AM for a bed)

Are there any systems out there that have distress codes or formal ways for requesting emergency law enforcement assistance? I'm not sure why we don't have a system for calling for assistance, especially in this area. Maybe because we have an entire fire station show up to most calls, they assume we're safe (even though we're often alone before and after they show up). I have a concern that if I ask for help in a rushed manner, I might not get it right away. When one crew witnessed some kids shoot someone down next to their ambulance, then turn the gun on the crew, hitting the glass to get them out, they radioed in "CallPD!CallPD!CallPD!" Of course, instead of dialing PD before the transmission even ended, dispatch was apparently confused, ask them to repeat, tried to reach them on Nextel, replayed transmission, discussed, then eventually called. I know they're not police dispatchers, so I'll blame it on lack of training, but I'd prefer to have a method that gets PD on the line without hesitation. You hear this code, you dial that number. Period. PD is usually only seconds away, so that extra time does make a difference in them getting there before the damage is done.

I know that an auscultated blood pressure is better than a palpated one. I'm just wondering if anyone has further info on HOW MUCH more accurate an auscultated BP is. Thinking about it, it almost seems like a palpated would give a more accurate systolic since you might miss the initial beat sound if it's too low volume, less-than-stellar-hearing (like what I have thanks to the siren), or just if there's background noise. But with palpation, unless you're in a bumpy ambulance, you're not really going to miss the pressure against your fingers from first beat of the pulse coming back. Now, I assume the answer is that that the systolic pressure is different when auscultated versus palpated, even if done perfectly. But how different? (BTW, I noticed a number of new hires placing the stethoscope heads, still over the brachial, but almost halfway up the arm and under the cuff. They get decent BP's and it's the way they're being taught. Anyone else do it that way? I was taught to basically put it almost over the AC right over the point where you can feel a pulse.)

Frame it on the wall. That's the one thing Dust still needs. Members to start sending in Dust-shrines. That's when you know you've made it big

I'm not even sure why we're getting that deeply into human development in this conversation. Obviously, there are large differences between a 16-year-old and a 20-year-old, especially psychologically (and we discussed that relentlessly earlier in the thread), but honestly there's not THAT much difference when it comes to understanding and memorizing EMT-Basic curriculum, ESPECIALLY if you're picking the brighter more self-directed students from a good educational system (which I assume Darien has, if it has money). Minus the psychological aspects and how that might affect interactions on-scene, I would probably place my money on a Darien youth EMT than with a 20-year-old volunteer with same field experience level. Unless there's something I'm missing here....but it hasn't clearly been explained as it related to the academia of the job.

I think there's a fear concerning what happens when the systems go down and the EMTs aren't excellently proficient at mapping. You can rely on electronics for a lot of things, but for EMS, maybe we want to give it some time. A lot of these integrated dispatching/GPS systems still go down in individual rigs.

That's not really explaining much. Explain how that affects their ability to remember and then identify information when they see it in the field. This is EMT-Basic class, not rocket science. The 2nd and 3rd top students in my EMT class were in high school, both 17, I believe. An intelligent student given this opportunity (especially if pre-med) is realistically going to treat it seriously and will try to do their absolute best. The problems I see are with aggressiveness and handling unstable mature situations/environments, but not with direct medical skills such as recognizing a life threatening injury. BTW, which EMT do you guys use. If only ours had a chapter on human development. We had 40+ chapters, I think, but closest we got was a couple pediatric chapters.

You mean Richard with tongue in cheek? Didn't seem to firm to me...too long of a post for that..

I don't get the point of that statement. Things like that are based on training and accompanying relevant education, not being 16 versus 18 or 20. Provided they had a good EMT class, I medically I'm sure they are either equal to or superior to first-year EMTs in their early 20s. Probably as many lives saved by a 26 year old volunteer. You're not really supporting your statements on HOW age plays a role in their medical abilities. Also, I imagine if this system has been going on for decades, they must have a better driving record than most ambulance companies... I'm not saying it's appropriate for 16 year olds to be the main crew of the ambulance (I posted earlier against that), but am asking you to explain your statements.

Lemme check...hmmm...nope not too much...carry on. BTW, I'm sure you realized he wasn't saying to use it as an actual medical training film for learning skills and such, Richard...

Awesome to hear, Dwayne. Exciting times.

Seaon FOUR! Just now? Must've needed a lot of editing...

It seems most FF/Medics prefer FF'ing first, though there are some that seem to like working the squads. I think most county FD stations that have a paramedic squad have three FFMedics per shift and they rotate on who works the engine (though if they're first on-scene they still do their ALS stuff if their engine has the equipment). I'm not sure how LAFD does it, but I see some of the older guys in the hospital all the time. I think they want a slower pace? Or maybe they're some of the single-function paramedics (which they don't hire anymore). I've been told FF/EMTs are rotated into the LAFD BLS ambulances "forced to work the box" as they put it. But seriously, if you like EMS don't you'd hate working anywhere in LA County. Like Dust said if you work for most private companies, you'll be doing mainly IFTs. If you work for a 911 private company, you'll be doing mainly EMT work but getting to start lines and such under FD's direction. The medical authority on-scene (the Fire Captain) might not have ever been a paramedic (though usually he is, but cert expired).

You're a member of the EMS service in the video I posted about? If so, please share more. It's stirred up quite a discussion.

You can all feel free to mail me said series I have watched MASH a few times when I was home sick in HS

Here's two non-glamor videos: (ambulance part starts midway) and

This is what I'm used to. Only County FD video I could find...the only thing off about it is that a FF is helping maneuver the gurney...that's RARE unless it's a full-arrest. Their c-spine technique and standing around practices seem about right, though. http://youtube.com/watch?v=aiQsCiv7RTU

Okay, I know this is borderline whackerish, but it's one of only two EMS videos ever I've actually enjoyed watching. Obviously, it's showing the exciting portions of the job, but it's hard not to have a boring video otherwise. It's the only one I've seen that shows defibrillations. And it doesn't have a high adrenaline soundtrack, either. I'm still waiting for the perfect video, though: scenes from station, scenes of doing paperwork, grieving families, tight fits, heavy patients, bodily fluids, ...guess it'd be hard to edit it all and still pleasant to watch.... (sorry, they disabled embedding, you gotta click on the link)

Yeah, when LA's system started there were already a few others in existence, but I don't know how similar/different they were. I've never watched an episode of Emergency! but from what I've heard "Ramparts General" was meant to be Harbor General Hospital (including the screen shots they used). We transport there often. Apparently, you could sometimes heart radio transmissions in the background to St. Francis Hospital....that was actually a second MICN station they used. I don't know any of Seattle's history, though...

I'm pretty sure USC is within Los Angeles proper city limits...but the I'm sure it's very close to unincorporated (run by County FD) or smaller cities within LA County (which are also run by their city FDs). I don't know what your academic background is, but you might find some rewarding tech jobs (with decentish pay) at some of the nicer hospitals, like Cedar-Cinai

All ALS is FD. AMR MIGHT have dual medics, which allows FD (I BELIEVE) to hand off patient to them (maybe). Do your schooling in LA, work as a medic out of county (Kern, San Bernardino, Riverside)

Well, I'm out. We had a patient exactly like that last night. As soon as we rolled into ER, the doc called it was one of those. Turned out to be both...but sepsis was the main one.