EMS49393

Overdose calls are unsafe scenes by our policy. Police secure the scene before we go in. That makes your question easy to answer. I would go available. When the PD find them, they'll let us know.

Looks a lot like the old pac-racks we had for the ferno cots. How secure? Not very. So NOT secure, we eventually did away with them entirely for safety concerns. As for the stryker version, I wouldn't bet my meager paycheck on is safety. How old do I have to be when I can start telling people their school sucks? (I actually did tell someone their school sucked tonight at dinner. They told me they didn't have to have any pre-requisite A&P. She felt she got all the A&P she needed in the first week of paramedic school. I actually put down my sushi, turned to her and said... "No A&P? Your school sucks." My friends know I never put down my sushi.)

Valid point, JP. I dare to say it often takes a tragedy to change a person. When I started in EMS, I never thought about securing items in the back, including myself. After all, I was young, and we all know ambulances never crash. Sort of like how police cars never crash. :? Well, about six years ago, a colleague was killed by a flying oxygen cylinder in the back of an ambulance that had crashed. From that moment on I made the conscious decision to secure items, secure myself, and pray the person driving had enough sleep before their shift. I know a lot of medics that never secure anything. I preach until my head turns red, and it doesn't change how individual providers carry on day to day. All I can hope is that I reach the next generation, and that they be a safer, and better educated generation.

I'm an airway seat paramedic. I try like hell to accomplish everything I need to before that truck starts rolling so I may strap my ass into the safest, and most valuable seat in the back. My service uses a modified squatted box, which makes it about three feet shorter than regular boxes to allow us better access down narrow alleyways. The stretcher just about butts up to the bottom of the captains chair. Lucky for me I'm only about five feet tall, so leg room is never a problem. Let me tell you (USApride) something, oh young, and rather insulting little EMT... I, like most of my colleagues, worked long and hard for the privilege of providing care to patients in a mobile fashion. At your very young age, and hence, few years in this field, do you really have a right to go off half-cocked and accuse providers of neglect simply because they prefer the idea of going home to their family should you inadvertently crash the ambulance they are in? I sit at the action table of my truck, in the captains seat, directly to the head of my patient. I have access to the patient, the patients airway, oxygen, and I can safely keep my monitor strapped in where I can see and hear any changes. If I have to get up to attend to an IV, I prefer to strap myself into the bench seat while I fix the problem, before moving back into my preferred seat. Rarely, almost never, am I up and around in the back of the truck while it is moving. I have a great dog that I love coming home to at night. There are very few things in this world that I do not like. I do not like things flying around in my ambulance, including monitors, portable oxygen, and myself. I do young EMTs that think they know everything, and I do not like Barry Manilow. As for the former paramedic in this article, the jury had deliberated at press time. You'll see the state has finished its investigation, and has already made its recommendations in regards to who is, and who is not, going to remain in EMS.

Believe it or not, Arkansas Emergency Transport (AET) is a combination company. They hold the 911 contract in a few areas of central Arkansas. This point, I'd be shocked if they had more than 2 contracts at present. The post below sums up what type of quality organization AET is much better than I have done. Sadly, the "intoxicated" medic commited suicide before she was punished for her behavior. Guinness, K.

How about revoking the license of the company, period? Notice how they thought it would be a bright idea to re-hire this sub-standard paramedic because they "thought his kills had improved." Wow, what a slip... that is "his skills had improved." That was really unintentional, really, I swear it. I might add to this story, this is not the first time AET has gotten themselves in hot water over their practices and paramedics. No mercy. Guinness, K.

I can't even start the discussion on this article, since I'm still in bewildered awe. http://www.nlrtimes.com/articles/2008/03/14/news/nws02.txt Family blames ambulance company for death By D.J. Smith Staff Writer djsmith@nlrtimes.com Thursday, March 13, 2008 3:07 PM CDT This is the ambulance used to transfer Frances Kiehl from Rebsamen Medical Center in Jacksonville to Baptist Health Medical Center in North Little Rock on Aug. 17. (Photo courtesy of Arkansas Department of Health) On Aug. 17, 2007, Eben Kiehl signed a consent form that said he understood the risks and benefits of transferring his wife of 46 years, Frances Kiehl, from a Jacksonville hospital to another hospital for doctor-prescribed dialysis treatment for a kidney infection. Six days later, 66-year-old Frances Kiehl’s family buried her. Kiehl died of cardiac arrest from an inability to breathe properly and subsequent oxygen deprivation to her brain, her daughter said; the family blames the ambulance company that transported her. After a state agency conducted an investigation, it recommended that the company, Arkansas Emergency Transport (AET) of Jacksonville, be put on probation for a year and that one of its employees, basic emergency medical technician (EMT) Mandy Sollock, be put on probation for two years. It also recommended that the company suspend EMT-paramedic Jerry Tharp and the state revoke his certification. As of press time, a representative of the Arkansas Department of Health had not returned a phone call asking whether the probations, the suspension and the license revocation had been carried out. The Arkansas Department of Health’s Section of Emergency Medical Services and Trauma Systems received the paperwork on Kiehl’s transfer from the Jacksonville-based Arkansas Emergency Transport on Aug. 22. That normally would have been the end of it, said Larry New, a section regulatory administrator with Emergency Medical Services and Trauma Systems. Because the department is “complaint driven,” New said Monday, the incident became a full investigation once Frances Kiehl’s daughter Diane Chism of Sherwood called his office Aug. 24. Chism made six more calls and sent many e-mails to New during the investigation. In late February, the investigation run by New was completed and Emergency Medical Services and Trauma Systems recommended that AET ambulance service be put on probation for a year and basic emergency medical technician (EMT) Mandy Sollock for two years. It also recommended that Tharp, the primary medical person in the ambulance, be suspended immediately from his job at the Brinkley-based Southern Care Ambulance unit in Clarendon, where he went to work after being terminated at AET. And it directed the Arkansas Health Department “to seek permanent revocation of his Arkansas EMT Paramedic certification.” After the termination, Tharp went to Emergency Ambulance Service Inc. (EASI) in Pine Bluff looking for a job, but EASI wouldn’t hire him until the investigation was complete, he told New on Aug. 27. Gary Padget, chief executive officer of Southern Care Ambulance, said Monday that Tharp was fired from his job in Clarendon after Emergency Medical Services and Trauma Systems called Padget during the last week of February. Under confidentiality regulations, Padget said, when an ambulance company hires an EMT, the state will disclose only that he is certified. Whether a person is under investigation is not disclosed until the investigation is complete, he added, because “everbody gets their day in court.” “It is set up to protect the innocent,” Padget said. “But as an employer, I would like to know these things at times.” AET supervisor Lance Hinds told New that AET had terminated Tharp on Aug. 24 for failure to “meet employer’s standards.” This was after an in-house investigation, but AET previously had fired Tharp once in Izard County, operations director Shawn Collins said Feb. 18. The Izard County firing was for multiple incidents of Tharp’s acting “against medical advice,” in which he did not transport a patient who was hypotensive (exhibiting abnormally low blood pressure), Collins said. AET hired Tharp the second time after he completed his orientation June 4, 2007, because, “We thought his skills got better,” Collins said. The 11- to 12-mile trip for the Sherwood resident from Jacksonville’s Rebsamen Medical Center (now North Metro Medical Center) — which didn’t have dialysis equipment — to Baptist Health Medical Center-North Little Rock would have taken 12 to 15 minutes at the speed limit, according to Internet research. But when Chism, driving her own car, arrived at the North Little Rock hospital, she discovered that the AET dispatcher had sent Tharp and Sollock to Baptist Health Medical Center in Little Rock with Kiehl, another 15 minutes away. The transfer paperwork given to the crew had the North Little Rock hospital listed as “BMMC” (Baptist Memorial Medical Center, the hospital’s old name), with “BMC” (Baptist Medical Center, the Little Rock hospital’s old name) crossed out. Chism, waiting at Baptist Health Medical Center-North Little Rock on Springhill Drive, was nervous when the ambulance transferring her mother took more than an hour to arrive, she said Friday. She said that when the ambulance arrived, she, her father, her daughter and her mother’s sister saw two people in the cab (the front of the ambulance). She assumed another EMT was in the back with her mother. She then saw Sollock walk slowly toward the back door and turn back to get something from the cab. When Sollock went toward the back again, Chism’s daughter Shannon Horton, 26, went to help her with the back door. Sollock later denied to New that Horton helped her. When the back door of the ambulance was opened, Chism was horrified to see her mother’s face visibly blue with her head and shoulder hanging off the gurney — and that there was no paramedic with her. Chism said Sollock then ran to the emergency door, hit the outside intercom and said, “I have a code out here; I need help.” In the report, Sollock said Tharp was in the cab, called her in, told her to close the door so the family couldn’t see and said he couldn’t find a pulse. Sollock said Tharp then told her she should summon hospital emergency staff. “I saw what I saw,” Chism said, “and I started screaming, ‘Mom’s gone, Mom’s gone,’ ” when she saw Sollock run to the emergency room door. “I think I went into some kind of shock,” she said. Kiehl’s sister, Sue McHolan, who was coming out of the emergency room, told her she saw Tharp get out of the ambulance through the passenger door, “just stand there,” then move to the back of the ambulance and place his hand on Frances Kiehl’s chest. The 61-page report said that, even if the investigators accepted as truth Tharp’s statement “I am 200 percent sure I remained in the patient compartment during the entire transport,” he was not free of culpability. “He did not provide adequate patient care as expected by an Arkansas certified Emergency Medical Technician-Paramedic,” the report concluded. In her interview with New, Sollock said she was the only person in the front of the ambulance when it arrived at the North Little Rock hospital. New asked her twice whether she knew the implications of falsifying information. “I understand that, and I would never cover for anyone jeopardizing my EMT certification. It was too hard to get,” Sollock said after New said several people had reported seeing two people in the cab. Sollock told New in person that on Sept. 17, “once at Baptist Medical Center in Little Rock, Jerry [Tharp] entered the emergency room.” The hospital staff reportedly told Tharp he was at the wrong emergency room, she said. But in Sollock’s handwritten report of Aug. 28, she said Tharp informed the Little Rock hospital by radio that they were about five minutes from arriving there. As they pulled up and she got out, Sollock heard the Little Rock hospital respond by radio that the ambulance crew should check its destination. Sollock said Tharp already had pulled the gurney from the ambulance, but the two reloaded it after Tharp talked to AET’s dispatcher to confirm that they were at the wrong hospital. Tharp told New on Feb. 11, “The patient was never removed from [the] ambulance, as far as I remember.” On Dec. 5, New again interviewed Sollock, who said this time that upon arriving at Little Rock, “neither of us went into the emergency room.” Tharp told New that the trip from Little Rock to North Little Rock took 15 minutes. He said Frances Kiehl started to foam at the mouth as they drove up the street to Baptist-Springhill and was in “code” as they backed up to the emergency door. Sollock said she noticed a flat line on the cardiac monitor in the ambulance, indicating that Frances Kiehl had gone into cardiac arrest. Emergency room personnel got her heart started shortly after she was taken into the North Little Rock hospital, but she never regained consciousness. Five minutes of hypoxia, or oxygen deprivation, can cause irreversible brain damage, according to the National Institute of Neurological Disorders and Stroke. Chism and Eben Kiehl took Frances Kiehl off life support Aug. 20 after the neurological testing that Chism requested showed no indication of brain activity. Frances Kiehl died five to 10 minutes later, Chism said. According to the state’s report, when Daniel Furr, the emergency room nurse, entered the ambulance to help Tharp, he noticed that the tube to the ventilator was “twisted and kinked.” Once this problem was corrected, Furr said, “Ms. Kiehl’s color began to improve.” AET’s record shows that the ventilator was working before the transfer run, according to AET fleet manager Robert Cole, but it was sent out to be reconditioned the next week. New said no record of Tharp’s training on the ventilator could be found in his AET file. Another problem was electrocardiogram strips from the cardiac monitor were missing from AET’s files. The one attached to the bill for Frances Kiehl’s transfer was found to be another patient’s electrocardiogram strip from four days earlier. When asked, Tharp said he had placed Kiehl’s two strips in his shirt pocket and inadvertently washed and dried them at the office. The AET office didn’t have a dryer hooked up until two months after Tharp was fired, Cole said. Tharp later said he must have hung the shirt up to dry. Tharp said the cardiac monitor fell from a chair in the emergency room that day and the batteries fell out. Cole said that without batteries the monitor loses its information after five minutes. Neither Sollock nor the ER nurse could attest to seeing the monitor fall. The monitor has a safety clip to hold batteries in, and an attempt by investigators to open it was extremely difficult, according to the report. The invoice AET sent for Frances Kiehl’s transfer had a charge for a pulse oximeter, which sounds an alarm if a patient goes into hypoxia, though this unit was never on the ambulance, the report indicates. Chism said she had trouble over the five months of the investigation. She said she got only two to four hours of sleep a night for three to four months. Sleep still is difficult on some nights, because, “I think this [report] has opened it all back up,” said Chism. But she said the report was worth the wait. “Oh, I was pleased with the fact that they were so thorough,” she said. Her dad still has a hard time, too, and can’t even clean out his wife’s clothes closet, said Chism. She said she stands in the closet when she visits her father, “because it smells like her.” Chism said she wanted to tell her mother’s story so people know that “just because you think you can trust [that] people are doing their jobs, it isn’t always true.” She later found out that, even though she was told she couldn’t ride in the back of the ambulance, a person is allowed to ride in the front seat with the driver.

I can beat that nursing home to hospital story. GBMC (Greater Baltimore Medical Center) in Towson, MD has a radiation treatment center that is in the same parking lot, less than 25 feet from the main entrance of the hospital, and the sidewalk between the entrance of the hospital to the entrance of the center is covered. I have moved many patients from the hospital under this awning for radiation treatment, and back again. It took longer to walk from the ambulance parking to the main entrance, than main entrance to radiation. :roll:

I was soooooo going to stay out of this discussion. First, I love Kentucky. I lived there for a while several years ago, and it's absolutely beautiful. The first thing I remember about Kentucky was how clean it smelled after it rained. Regardless of rain or drought, my own hometown just smelled like cement dust and cancer. Like most paramedics that actually care about career advancement, I hate the idea of an EMT-I, unless they are under direct supervision of ME, and do not do anything until I say it's alright. After that, they're more than welcomed to get up front and drive. I'd be a big fan of the double paramedic truck, however I have control issues. Aside from control issues, I haven't met many paramedics that are even remotely close to having the education I choose to devote to my career. Perhaps that's why I spend so much time on EMTCity. I crave intelligent conversation. One of my closest friends is a paramedic with the service in the article. I brought this discussion to his attention today. He has no problem with the EMT-I, as long as they are under his direct supervision, and do not do anything until he says it's alright. Sound familiar? He did tell me that another reason they pushed this EMT-I program through was to take the load of all the "ALS" IFT's off the few paramedics on the shifts. He cited that he is often on an "ALS" IFT, only to find that the patient is going from a CCU/ICU to a lesser monitored bed in a hospital, and often they are not even going into a telemetry bed. I could be wrong, and I'm sure Dust, Ruff, and Rid will correct me if I'm wrong, but how is a patient going to a step-down, or ortho rehab floor an ALS transfer? With that being said, those calls above are perfect BLS transfers calls. What is the point of the EMT-I in that case? Hand me some Excedrin, I have one hell of a headache now. My friend says he likes the extra hands. I can count on one hand when I might need an extra set of hands that can perform ALS "skills." I might need someone that can start an IV and push a round of code drugs while I'm attempting to get a difficult tube during a cardiac arrest. I might, and sometimes, I might not. I currently work with a basic. I can't sing her praises enough. She is one of the chosen few basics I like working with out of the 200 or so in my service. I rarely have to tell her what to do. I worked two critical calls with her in the last two shifts, and despite having two incredibly useless fire crews making every attempt to get under my feet, the calls went very smoothly. (They really smoothed out after I booted the firefighters out of my truck. ) She knew I wanted a tube set up, and IV set up, the monitor and combo patches on. I never had to look up from what I was doing to say "Ugh, will you please put the patches on so I can try to pace!) Funnily enough, she had enough basic "skills" to perform on those calls, that she wouldn't have had time to help me with any of the ALS things I had to ponder and perform. In all honesty, the thing that really ticks me off about this EMT-I thing in Bullitt Co, is the pay rate. They are making more than I am, and I went to college! :shock:

Ahhh, the days when I worked private ambulance. I try hard to block that period of my life out of my memory. Yes, I have run this call, numerous times. Yes, I have been asked to re-write a report and falsify documentation to meet medicare approval. I refused to falsify documentation. I was threatened with my job. I went above the supervisors head and cited the story of the ambulance company that once was, and is no more because of medicare fraud. I worked private ambulance in the Greater Baltimore City region for many years. I spent most of that time with one company, they shall remain nameless, and they still exist. There was another company, perhaps the largest rival of the company I was employed with. By huge, I mean they were HUGE. They had the largest hospital system contract, they had numerous ALS trucks, and three or four critical care transport units. They also had a crooked owner that had a gambling and drug problem. They billed for fictious transfers, they double and triple hauled ambulatory dialysis patients that they individually billed medicare for. Eventually, they were caught. Not only did they lose the ability to bill medicare, every other insurance company refused to allow them to perform services. They were also fined, in the several million dollar range. In the end, they had two or three BLS trucks left of the fleet, and were only able to take medicaid calls at a whopping $70 a pop. The moral of the story... Go ahead and falsify documents because you're not strong enough to stand up to your boss and say something is wrong. In the end, you'll lose your job anyway when the powers that be figure out who is cheating them. There are always other jobs.

Is this a joke? Eleanor, did you signed up for this forum so you could insult us? I find people that automatically assume we are arrogant selfish. I'm personally quite compassionate with my patients that are having emotional problems. I lose my compassion when I'm faced with repeat offenders that refuse to do anything for themselves and whine about how the world is so bad to them. At some point and time you need to grow up and be accountable. If you need therapy, go. If you need medication, then take it, but for God's sake, quit being a victim. It's played out. By the way, there is a little spellchecker button on the bottom right hand corner of the post box.

Well, all I can say is "this bites." I've been researching and lobbying for fentanyl in our service since I came to work here. My previous service carried fentanyl and it was my narcotic analgesic of choice in a lot if cases. I particularly loved it for my elderly ladies with hip fractures, or anyone that had an obvious fracture that was going to hurt like hell when we moved them. I love that it's short acting, doesn't create the hypotension morphine sometimes does, and wears off quickly. I could make an 80 year old lady very comfortable with as little as 20 mcg. I wish I could say "how can a paramedic be so stupid?" I just can't, because I know first hand of a medic that refused to use fentanyl because they didn't know what it was and they weren't comfortable administering the drug. I can't fault a provider for being cautious. I can, and did, fault him for not taking any initiative to research the medication. If something is on your truck, you are responsible for understanding it, period. I say again, we just do not have enough education. We also do not have enough pre-testing to try and cut down on some of these yahoos becoming paramedics. Disgraceful.

Damn college students... I bet you even know how to write up a bibliography when you construct a paper, ya over-achiever, you. :pottytrain1:

I have my own gut feeling about taking a double IFT. It feels wrong to me. It especially feels wrong to me when I'm forced to double haul psych patients. That spells a recipe for disaster to me. I can just see patient number 1 giving the beat down to patient number 2 because Jesus came to him on a cloud with a ukelele and made him do it. Now when it comes to multiple patients at a scene, I've hauled two criticals, one on the stretcher and one on the bench. If I have to do this, I make sure I grab one of the firemen that I know is a paramedic (a paramedic I trust) and we handle it. I've hauled up to four 20 year olds from a fender bender with various complains such as "I can't bend my wrist this way anymore," or "it really hurts behind my knee, do you think it's broken?" Let me add that all of these kids were much more interested in cell phoning their friends and telling them all about their near-death experience, than talking to me. Perhaps I'm just boring. I digress... I don't know how HIPAA feels about this double transport thing. I can only say that if it feels wrong, it just might be wrong. Good luck with finding answers, the government can be mighty elusive at times. When you find out, let us know. Cheers, K

I'm glad to see there are people willing to correct the numerous errors I've read while browsing around the pages of wikipedia. I find wiki to be incorrect so often, that I routinely bypass any search that includes references to wikipedia. I guess I just want the truth, not a pill of crap invented by some uber-geek, hormonal teen-aged, basement dwelling, psycho youth that hates the world because they're misunderstood. Besides, I'm fairly certain any paper I present that even pays the slightest reference to wikipedia would most likely be burned, before it's even read. In response to the question about cleaning up the EMS entries, I would be more than happy to correct anything I find a miss. I actually look forward to this new way to spend my time at work.

I tried very hard to steer clear of this thread simply I'm a paramedic that enjoys a paycheck for my services (albeit a small paycheck.) I have no interest in being involved in a volly vs. paid, basic vs. medic debate. I have worn all four uniforms before. What I have is a tale of two ambulance services. Company "A" is a private, somewhat shady company contracted to provide ALS services in a small community of approximately 12,000 tax-paying residents. They are required by their contract to have at least one ALS staffed ambulance in the city limits at all times. Should that ambulance be sent on a call, they are required to provide another ambulance from a neighboring district to post until the original assigned ambulance clears the call. There is a station, and in front of the station sits an ambulance. A call is dispatched for a child injured at the local high school. Everyone feels secure, because their ambulance is just up the street, sitting in front of the station. Everything is going to be alright, the paramedics are coming. They were coming, and coming, and coming, but they didn't quite make it in time, and the child died. The ambulance at the station was for show. The live crews were busy running transfers, because transfers pay. The public sees an ambulance, and they assume that they are protected should they fall ill or become injured. We all know what happens when we assume. The private company was asked to leave, and their contract was terminated. I work for a third-service type entity, also known as company "B," in the neighboring community, and we were asked to come in and provide ambulance services for this small community. They have at least one ambulance in the city limits, or within a few miles of the city limits AT ALL TIMES. There is a moral to the story. You may see an ambulance, but that does not guarantee that you will have prompt and appropriate care when you need it. I digress from the original topic, however I just couldn't pass up this story, since it fit so well with Dustdevils comment. I have a lot of strong feelings about voluntarism. I started as a volunteer when I was a teenager. I have since seen all three companies I have been affiliated at one time or another become fully paid. Two of the three companies were fire-based, and still remain volunteer in regards to fire coverage. Apparently it's a lot easier to staff a fire engine with volunteers than an ambulance. I've heard every excuse in the world for why volunteers can't do something. "I have to work, I can't spend 500 hours in class to become an EMT-I." "I refuse to ride the gutbucket, I'm a fireman." "Oh, it's Ms. Smith's house, she's a pain in the butt, I'm not taking that call." I am a paid paramedic. When they drop my truck tones, I have a call, period. I can't pick and choose calls. I can't pick or choose what educational events I'll attend. If I want to advance, I better make sure I stay on tide with the changing attitudes in education. I, too, am sorry if I step on your first responding toes when I arrive on scene of a call. If the first word out of your mouth is "uhhh..." then I will probably dismiss you and begin the task of assessing and treating MY patient. As for HEMS, I applaud AK's post. If I'm calling for a helicopter, there is something really, really bad going on that I can't fix, and can't keep stable long enough to make it to definitive care. I expect a flight medic that is able to multi-task, and I have yet to meet one that can't. I expect them to begin their assessment and listen to my concise, yet important report while doing so. In return, I'll do my best to quickly disconnect my equipment so they may begin to connect theirs. I had a lot to say. Luckily for any readers, I'm able to use paragraphs.

I love education. If there is a class, and I'm off work, and I can afford to take it, I'm on it. I get a thrill from learning new things, new ideas, new techniques, etc. I refer to these little classes as "fluff" classes. They're great to take, great to have, but in the grand scheme of my particular job, they're utterly worthless. When I was hired at my current job, they asked me for five things... National Registry Paramedic Card State Paramedic Card CPR ACLS A valid drivers license They could give a crap less about any other class or card I carried. I have a file folder full of neato little cards worth less than the ink used to print them. Currently, I possess 11 different fluff cards. Perhaps if my boss knew I had all of these cards, I might get a 3.1% raise instead of a 3% raise this year. To the man that signs my paycheck every two weeks, I'm a paramedic and nothing more. Heck, most of the time I'm just a babysitter. However my hobbies do include suctioning the filling out of twinkies, standing around while the fireboys do all the heavy lifting, and pencil sketching street signs. Now, if you'll excuse me, I have to modify my occupation to include all my hobbies and certifications... :roll:

Personally, I found the paramedic exam to be ridiculously easy. I went through a good college-based program, I studied, and most of all... I wanted to be a paramedic. I had a crappy EMT instructor. It was a fire-based EMT class, and most of my classmates were there because they were required to be at least EMTs to ride the fire engine. There was a high fail rate despite the spoon-fed state test. National registry was not required at the level, and in fact, discouraged. I passed the state, easily. I went out of state to take the national registry, and passed it the first time. It's no secret that a lot of the EMT and paramedic factories out there are simply horrible, but in the end, the responsibility to learn and understand falls solely on the individual.

I agree with Dust, I often agree with him, I just hide it well. My post was not aimed at you, it was aimed at your program. I applaud anyone that wants to learn, practice, and become the best provider they can become. I have a problem with a majority of educational programs. I met a young man a few days ago that is doing his ride time for his EMT-basic class. He was a nice young man, near the end of his class, and he had no idea how to take a blood pressure or how to put on a nasal cannula. I wasn't mad at him for not knowing how to do these basic skills. I was furious with his instructor for letting this young man begin his ride time before he taught him how to do these skills. He informed us that his instructor told them all at the beginning of their class that he has an average of 2 people in each class that actually pass their national registry exam. We're talking a class of more than twenty people. Considering how easy the national registry exam is, it's a darn shame his pass rate is so poor. I'd venture to say, the common denominator in his class fail rate is HIM. This young man wanted to learn, but he was stumped on where to even begin. He told us that his instructor has told them to bring their stethoscopes to class every time because he was going to teach them how to take a blood pressure. Apparently, that never happened. I don't see how we can ever hope to build strong providers if the education continues on the path it is currently on. I certainly hope that you stick around. There is an abundance of education and experience on this forum.

Taking any arrhythmia course before a comprehensive understanding of the anatomy and physiology of the heart, lungs, vascular system, etc. is setting yourself up for confusion and failure. ECG's are incredibly easy when you understand what each of the "funny little complexes" actually represent. Just my $0.03. Good luck with your education, and remember, the learning never stops.

During this "PASTE" part of your schooling, did your instructor give you the percentage of patient that will look at you like you had fire coming out of your butt for asking some of those questions? For the life of me, I can't believe you can't figure out if a patient is speaking in partial or full sentences before you get to the counting thing. Is your instructor still using the "who is the president" question to determine if a patient is oriented? I now return to my corner to suck my thumb and cry over the future of my career. :binky:

"I'm special and gosh darnit, people like me!" :hello1:

"See your doctor." I'm not a freelance paramedic.

When I got my paramedic license I was required to work 90 days, full time, with a field training officer paramedic. Now that I have experience under my belt, I tend to be a lot harder on myself when it comes to my clinical decisions. I agree with the respected few here, you should never feel 100% comfortable. You're a paramedic, not God.

Heeeeeellllllllll NO! If people know I'm a paramedic, they may expect me to help them, for free. That's just not my style. I do have a HON sticker on my car, from Cafe Hon in Baltimore... hometown, place I love, place I long for, place they'll bury me when I'm finally picked for my celestial transfer.