EMS49393

Can't really say that's my typical day. I don't argue with dispatch, that's like shooting the messenger. It's not their fault a nursing home sits on a patient that ill. It's also not the patient's fault that they are ill. It may not even be the nurse's fault that they sat on the patient all day. They have protocols, and they often state that they can't send a patient out until labs are reviewed by the physician. He may not have gotten the lab work until 11 pm that night. Do you know how serious abnormal labs can actually become for a person? Very serious, and very dangerous. Besides, running calls doesn't bother me like it seems to bother a lot of other people in EMS. It's my job. If people didn't call 911, they wouldn't have a reason to keep me employed. Just so no one has their feelers hurt, this post is NOT directed at the OP. It's just a statement on the video itself. Let them get their bearings here in the city before they get their butt jumped on. Plenty have posted those text to talk videos so it's only natural to think others here may find them funny. I don't, but I guess some people do.

I bet with proper documentation, the state may be willing to work with you. Certain states refuse to accommodate anyone that doesn't meet their standards, but if you continue to search I bet you'll find at least one (hopefully Illinois) that will help you. Your class is longer then the traditional EMT program in the US. The course is 120 hours here, and most students only get 8 hours of ER time and 8 hours of a ride along. Many classes use that particular EMT book. Good luck, I hope they are able work with you.

How many hours is the EMT course in your country? I have a feeling that many states have never been faced with someone from another country looking for reciprocity. If you can provide total hours, a breakdown of trauma, medical, clinical, etc., hours, and your skill set, the state may work with you. Pharmacology-wise, you're ahead of most basics in the states in which I am familiar.

Directed at people that feel they are tricky after knowing for certain what the questions contain. She did not. She was told they were tricky, she did not know for sure. You can argue this point with me all you wish, and I will not change my stance nor apologize for being honest with people that feel that is a hard exam once they have taken it. I've taken harder 8th grade algebra exams. Someone with a college education should have NO problem with the test.

You can take a CPR class as young as 10, so you're old enough for that class. There are volunteer fire departments that have junior programs in some areas. You can often join at 12 or 14. Although you can't ride any equipment, work on patients, or any other emergency related details, they often have trainings that the juniors are welcomed to attend. I know of some departments that have substantial junior memberships and they do all sorts of fun trainings with them including getting out the manikins and running scenarios, setting up mazes and allowing them to gear up, and of course, many let them ride in parades. If you find the right department you can have fun, learn a lot, and most importantly, stay off the streets and out of trouble. Most departments also require their juniors to maintain a certain GPA which hopefully helps the kids keep from flunking out of school or repeating grades. I'm all for these junior programs. Hopefully it serves to keep kids off the streets, off drugs, out of gangs, and help them to develop a sense of responsibility. What is your region in PA? I'm in York Co, and our region is under the EMS Federation. I'm not sure how many counties fall under the Federation, but their website is www.ehsf.org. There is some information on that website, although I'll warn you now, it's sometimes difficult to navigate. Good luck and keep us posted.

It's not a slam, it's honesty. I've had plenty of people talk to me that way in my life. My father is the biggest culprit. Without him being brutally honest to me, correcting my grammar and spelling (often in public), and pressing the importance of education upon me, I would not have come nearly as far in my life. I'd probably be a high school drop-out. I am also this brutally honest to my ten year old child, and he gets to spend some of his summer vacation being tutored by his horribly honest mother so that he is ahead in the next school year. Education is paramount in my family. I never questioned her reading comprehension. I made a general statement that the questions are not tricky if one has obtained a certain level of reading comprehension. Obviously this girl has some sort of education to be in her current career, so it would seem to me that she has either passed the exams for college level reading, or taken the necessary courses to get her to the level required for her job. So if you if you are able to understand what you read that test is a breeze. Don't try to tell me they are tricky questions, because they are not. I've taken that exam at both the basic and paramedic levels, and those questions were far from difficult. She had a well thought out rebuttal. She passed that thing after 70 questions. She was a ball of nerves, not an idiot. My post was designed to tell her that if she is able to understand what she reads, she'll have no problem with the test. I expect my supervisors, friends, and family to be honest with me. I don't need anyone blowing smoke up my rear-end. I'm not the sensitive, touchy-feely, my feelings are hurt because you brutalized my psyche type of person. It amazes me how sensitive people are when faced with a little honesty.

Don't discount working in a long term care facility believing that you won't learn anything about medicine. Those people are often elderly, and not generally well. They have multiple medical problems, medications, and assorted other issues. They require special care, and you would learn a great deal about patients with special needs, communicating with dementia patients, and taking care of the age demographic of patient most often encountered on the ambulance. If you find the right facility, you may find a nurse or several nurses that are open to someone that wants to learn more about general patient care. In general, long term care facilities get a pretty bad rap, but there are a few that have some fantastic staff. It's the same argument I hear from EMT's that don't want to do inter-facility transports because it's "boring." It's all what you make it. If you want to learn, this is your opportunity to start talking to patients about their medical problems, treatments, etc. You can start to correlate medications and diseases. Again, those people are often the sickest of the sick and have multiple needs and considerations. It's only boring if you make it boring. To answer your original question, most ER's I know will give preference to a CNA that is an EMT. Some states do not even require CNA to work in an ER and your EMT would be sufficient. I wish you all the luck in the world. I know what it's like to try to get an education and a job in an area that has little to know offerings within a 100 mile radius. The above was not to bash you, so please don't take it that way. I simply wanted you to consider that you actually might learn something from what would appear to be a boring job. I got to tell you, I've been a 911 paramedic for years, and there are a lot of times my job seems boring. EMS doesn't always equal excitement, but it does occasionally equal excrement. Good luck.

They are not tricky. People that say they are tricky probably have difficulty with reading comprehension. This is exactly why there should be a minimum standard for reading comprehension before these classes are taken.

Did you bother to read the entire context of the response? It doesn't meet the criteria that particular person was using to verify v-tach. I didn't comment either way on whether or not this was v-tach, my comment was based on the typical and very limited criteria a particular poster used to determine the rhythm. Unfortunately most paramedics in the United States have very limited cardiology and couldn't determine a rhythm with the most basic of criteria guidelines let alone be able to comprehend anything more advanced. I proved my point with my response. If a medic can't even determine if a complex has a positive or negative deflection, how can you expect them to be able to comprehend Brugada's criteria? Maybe if they started requiring a little more anatomy and physiology before they let people go to paramedic school they would understand how the heart functions thus understanding how to determine cardiac rhythms and treat patients appropriately. More education, novel concept.

I'm a total sucker for a feel good story. Thanks for posting, you made my night.

That is how I am reading the protocol. I'm fairly well read, and usually have zero problem with comprehension, but I feel this protocol might need to be worded a little better for clarity. I do what I need to do within my limits, and call for things I'm comfortable with that are outside my limits in this particular state. I'm asking more from an educational and quality assurance stand point. I appreciate the assistance so far and hope that I hear from more people on this topic.

My fellow providers, I need some assistance. Currently I work in Pennsylvania, and our current protocol for medication via nebulizer state we can provide albuterol 2.5 mg mixed with ipratropium 500 mcg. It also states that we can provide nebulizer treatments continuously. This is against what I was taught, and against the protocols in the past two states I have worked in and the state below me. I was taught that because ipratropium is an anticholinergic drug it is only to be given with one time, while the albuterol can be given continuously. At this point, I'm pretty confused, and honestly I only give it one time to my patients that require that treatment because that is how I was taught, and I don't really want to dry out anyone that might already be getting dehydrated if they've been battling a wicked asthma attack for several hours. Would one, or more, of my colleagues here please help me understand what is correct with regards to administration of this drug? Thank you.

Now that I live in Pennsylvania, I completely get your point. I moved here to take a job with a company that wanted it's own MICU. I was the first street paramedic hired. All of the other services in the area that are ALS are hospital based squad units. Aside from my company, there are only two other companies in the general area that have a MICU service, and they are RARELY hiring because of a low turn over. It takes an act of God to get hired by the hospital services, and you generally have to know people on the inside to get a spot. After almost a year, the company I work for is considering going back to letting the hospital provide ALS coverage rendering me jobless. Now, if I were an EMT-B, I could have my pick of jobs, as there are a pile of BLS companies in the area. My point is that there are areas in the USA where being a paramedic is a detriment. I really never thought I'd end up unemployed as a paramedic. I always thought that if I did a good job, showed up for work, put in my best effort, and helped out when needed that I would always have a job. I only wonder if I will qualify for food stamps while I'm collecting my unemployment.

Apology accepted. Just kidding. You know why you'll be an exceptional paramedic, Lone? Because you are humble and eager to learn more. In my experience, those qualities (along with some others) are absolutely instrumental in a good medic. I can't wait until you start class again. I'm excited that you'll be learning more and sharing what you learn. I bet you'll teach a few of us some things along the way.

Really? Because it looks to me that lead I is an up, not down. So, no it does not meet the requirements, as previously stated.

There is a huge difference between education and training. I have the knowledge to know why, how, and when because I went through anatomy and physiology, chemistry, biology, mathematics, and all the paramedic didactic. I also got to sit through composition classes, sociology, psychology, and a host of other humanities during college. This was my education. After my preliminary education, I began my training when I started my scenerio-based skills, clinical rotations, and ride time. Now I attend continuing education often, skills refreshers often, and I read and research almost every day. I am continuing to further my education using the building blocks I was given in college. You can train anyone to intubate, start an IV or an IO, or see a common rhythm - push this color medication box. Can you educate them as to why something should or should not be performed? Can you educate them as to why something is or is not happening to a patient? I'll tell you what I tell every basic that wants to do a bunch of "cool skills..." You tell me everything I already know about what skill or medication you want, and you would have my blessing to do it or give it to your hearts content. Until then, it is what it is, and you are what you are, an EMT-Basic. Incidentally, if a basic provider is able to bag a patient, especially in a code situation, then it is the paramedics job to obtain IV access first to facility rapid administration of medications in a hope to return circulation. So if I ask my EMT if they are able to adequately ventilate a patient and they respond "yes" then I am on to my IV or cardiac interventions. Don't believe me? Check the new ACLS algorithms. Of course if they say they can and they are lying to me it will be the last time I every ask them anything, and the last time they are ever on my ambulance.

It's called "empathy lab." They have you stick your classmates and vice versa so you know what how it feels to be on the other side of the sharp. There are a lot of people that dig for veins, and that hurts like hell. With an empathy lab you'll hopefully think about how important it is to be proficient at this seemingly minor skill. Many providers take it for granted that "it's just a little IV." Well, you can really make a patient suffer with just a little IV if you aren't good at the skill or don't understand how badly it can hurt when performed incorrectly. I don't know any person that went through paramedic that didn't have to be stuck by a classmate at least once. Heck, in my class we had to put pacing pads on our thigh and "pace" our legs so we'd have some idea of how uncomfortable that procedure is for a patient. How scared you feel right now is not nearly as scared as some of your patients are going to feel when they call for your help.

Just like a woman, I figured you had a baby. I open it up to find you had a motorcycle instead. It's amazing how different men and women are. I'm not a bike kind of gal, but it looks like fun.

It's a matter of preference. No one can give you the correct answer because it's up to the individual to decide what fits their needs the best. I have had the same cardiology III for the past 12 years or longer. I had it while I was an EMT-B and it went with me through paramedic school and now that I'm a paramedic. It's my stethoscope, I do not allow anyone else to use it, and it stays with me on the truck, or in my locker when I'm off work. I don't dig anyone's ear cheese and I do not want their dirty ears all over my stuff. I keep it very clean and I have the earpieces and diaphragms changed out regularly. It also gets a big swipe down with a cavicide wipe following each patient encounter. If you take care of your stuff, then don't cheat yourself and get a good scope for school and beyond. If you have problems keeping up with your belongings, then do yourself a favor and stay cheap. My instructor recommended we all purchase a decent scope for school if we did not already have one, so I disagree that you shouldn't consider upgrading if you know you are capable of not losing what could be a very expensive purchase. Personally, I can't hear anything with a cheap scope, and I don't think it's the scope as much as the earpieces. They are hard and do not conform to the shape of the ear and therefore do not block out ambient noise.

Why only the FDNY service? Having come from a fairly large urban service, the experience is pretty limited in that setting, especially with very short transport times. Absolutely, NO disrespect to FDNY meant in anyway, but you might be selling yourself and others short by not considering other areas as well, especially some of these areas that have wicked long transport situations with limited HEMS availability.

It doesn't. IMO, the autovent is garbage. Some people love the hell out of it. I prefer to a more hands on approach to my airway for short trips, mainly because I like being in control of my tube, and I'm very protective of it. For a longer transport, there should be a respiratory therapist with one of their portable vents going along for the ride if an autovent is your only option. I have to say, and it might be because I'm an American paramedic, but we are in no way trained well enough to deal with a long term vent patient, or trained in the use of the more sophisticated ventilators. Because of that, if a patient requires a long transport, they deserve a quality ventilator and a respiratory therapist that is well versed in their equipment. Don't get me wrong, I came out of a fantastic program, but we had our equipment. The RT's from the hospital and their portable vents didn't even come into our class. Do I really feel comfortable taking care of an obviously sick patient with a piece of machinery I have NEVER set eyes on, let alone used? I don't, and I bet my patient and their family doesn't either. So, if my option is an autovent, I'm going to use every other item of monitoring equipment in my arsenal. Including the fancy piece of equipment between my ears. I wasn't given this brain as a fashion statement, it was to use.

Perhaps I'm just overly cautious and nervous, but I would have also had the patient on a cardiac monitor along with EtCO2 while doing that transfer. The more safe-guards you have in place, the better your chances of a positive outcome. We can't break down charges where I am at, and a vent patient is automatically ALS, why not pull out all the stops to ensure a successful transfer? Yes, I understand they are on a chronic vent patient and do not require that type of monitoring in the facility, but I'm not in the facility, and I don't have a nice, fancy vent that alerts me for apnea or changes in CO2 readings. I have an autovent, which, to be honest, I really don't care for anyway, but aside from that, it doesn't have any short of alerting mechanism like a regular ventilator. Of course, one can always rely on their eyesight as well. Did they happen to notice the lack of chest rise and fall any time during that eight minute period, or were they buried in paperwork, or as someone else stated, mobile facebook? I also like to verify the presence of lung sounds through out a transport as well. Reassessment, call me crazy. This type of call is exactly why I hate doing anything but patient care in the back. The only time I'm not giving a patient 100% of my undivided attention is when I have to call the hospital. My reports are generally less than 30 seconds long, and I continue to watch my patient while I'm giving my alert. If my patient is critical, my EMT gives a brief report, or has our dispatch center notify the receiving hospital so they can prepare for an incoming critical patient. When I'm transporting a patient, the priority (along with our safety) is the patient.

Walking is HARD!

Congrats on your baby's milestone! Being a parent is one of the hardest but most rewarding jobs in the world. Every day is new, and most parents will learn as much as their children while they are growing up. I'm happy to hear you have such a miracle after so many sad disappointments. Side note, aren't babies tushies just the cutest in those big diapers while they're trying to crawl all over the place? And bellies, oh don't get me started on how precious baby bellies are. And little feet, ohhh, I love their chubby toes and little feet.........

Snoopy, If you are working for a service in PA, contact the EMS Federation, they should be able to tell you who your medical director is. If you are working in MD, contact MIEMSS and they can give you the information you seek. Medicare fraud is HUGE. I worked private service in Baltimore for many years, and about ten years ago there was a service that was convicted of Medicare fraud. This company was gigantic, with a huge critical care program, and the contract for what was then MedStar (some 7 or so hospitals). They ran a fleet of 30 or so trucks during the day. They were fined 6.2 million dollars, and not eligible to bill Medicare any longer. It shut them down to one BLS truck and they could only do private pay or medicaid runs at 75 bucks a pop. It devastated that place. Keep fighting. If they do anything to you for being a whistle-blower, it's illegal, and you'd have a lawsuit, so long as you could prove it. Document, document, document. Keep a diary, keep to yourself, and be a fly on the wall. Observe and record everything. Most of all, keep your nose as clean as you can, so they have no reason to treat you unfairly or terminate you. Should they terminate you, get your unemployment. You're doing the right thing. I'm proud to know there are people in this business that still care about why we are here, to take care of people properly, and to the best of our ability, and to never stop being an advocate for what is right.