EMS49393

I call AAA or my husband. Never trust anything, especially anything on the internet.

I don't think I would be able to live with only three albums. My personal collection holds over 10,000 songs, most of which are included in full albums. The three that came to me first: The Beatles - Rubber Soul Al Kooper - New York City (You're a Woman) Van Morrison - Tupelo Honey I don't expect anyone to know anything about Van Morrison outside of Brown Eyed Girl. I don't expect anyone to know ANYTHING about Al Kooper. I hope that anyone over 40 knows who The Beatles were.

I vowed I would never get married only because I never wanted to be divorced. My parents and both sets of grandparents are/were married to their original spouses. I can't say the same for all my aunts and uncles. I had been with my husband nearly four years before we got married. He had all the qualities none of the other men I had dated possessed. He has a job (actually 2) and an education. He is kind, funny, and somewhat understanding. He is also supportive and believes that relationships shouldn't be difficult, even when times are tough. Most of all, he won over my parents (nearly impossible to do). I only got married because I knew I would never get divorced.

1. Yes, however they have started to utilize the grossly inadequate paramedic for a lead basic on a BLS transfer truck. Examples of grossly inadequate include mistaking a head bleed for an acute coronary crisis (and being reported by the ER doctor) and transporting a dead body reporting the vital signs to be "within normal limits." I'm fairly sure the reason they can't be paramedics is largely based on complaint by ER physicians and less about the crimes they committed against the patch. I only say that because they still have many paramedics running functioning that have IQ's hovering around 80 that consistently make mistakes that aren't reported on. It's become so common many emergency departments simply dismiss the mistakes and set about correcting the situation. The upside of this phenomena is being recognized as a competent provider pretty early on by the nurses and doctors. There are a few of us that can ask for any order and NEVER be turned down simply because we've proven ourselves, over and over. Sucks for the public we serve, rocks for the handful of us. 2. I once worked at the perfect service. It took me nearly three years to prove myself. It's hard to do that when everyone you work with is uber-smart and educated to a level barely seen in EMS. I mean requiring actual college A&P, actual college English and math courses, having an entry level exam to weed out those that are lucky to be walking upright. The pay wasn't great. It was a hospital based service and the EMS-ER relationship was fantastic. Most trucks were double medic. The turn-over was low, the arrogance high. I will say this, they earned the right to be arrogant. Those paramedics were incredible. If I'm going to be sick enough to need EMS, I want to there when I need them. 3. No, generally they promote them. My current service is built on "yes-men." Those that challenge the good old boy system are the ones that take the most flack. I don't take any crap from the fire department, which is a problem because my service worships them. Medical call, my scene, my patient, do what I want or leave. I rarely need lifting help, and I don't need a bunch of people standing around with their thumbs up their butts gawking at my patient. Subsequently, I'm actually banned from working in one part of the city because I don't play well in the sandbox with the fire department. 4. Pretty crappy. When I first came in I had come from an accredited paramedic program taught by one of the best instructors in the country (Bob Page). I had oodles of hours of clinical rotations in every part of the hospital, including ER physician shadowing. When I compared my clinical hours with the program given here, I had more than twice the hours and had completed time in more areas of the hospital. I also had my previous college background on top of everything. The program here is six months long with a short little online A&P class. Because I didn't go to their program I was told I could only work as an intermediate with another paramedic for an undetermined amount of time. Most of the paramedics were still fighting the 12-lead and use of capnography, whereas I was educated in both and found them to be invaluable assessment tools. They didn't look at where I was and what I had done, they looked at where I HADN'T went to school. I offered to help with education of 12-leads and capnography and have been turned down every single time. I have to wonder if this type of company is a product of being in the south. I don't think I've ever worked for a place that is so close-minded and afraid of change. I've seen these people treat new people so badly that they've psychologically damaged them. I've seen one officer be so hard on a brand new EMT, the guy remarked that he felt near suicidal after his shifts. Having people that are supposed to be mentors acting like this, imagine how others act towards outsiders. I'm really lucky, I'm only there once in a blue moon anymore. I channeled my energy into another job. I hated knowing that the reason I needed medication was because my job sucked. I love being a paramedic more than anything in the world and I'd love to be able to teach new EMTs and paramedics. Unfortunately, it looks like I'm going to have to wait until I move back north before I will once again be able to work as a paramedic on a full-time basis. I've seen a lot of people have viewed this topic by next to no one has replied. I'm really interested in hearing how other services run. I hope some more people will honestly answer these questions.

Courtesy of the Notorious Cherry Bombs... It's hard to kiss the lips at night that chew your ass all day long. (I frickin' hate country music, but I found this just for you). Chicks can be a real pain in the butt, which is why most of my friends are men. Good luck, and I hope things straighten themselves out.

A spade is a spade and a wh*re is a wh*re. Thank you and goodnight.

I'm a BBC fanatic. Ramsay's Kitchen Nightmares (if I ever became divorced or widowed Gordon better watch out!), The F Word, You Are What You Eat, and How Clean is Your House. On Bravo, Top Chef and Project Runway. I'm not crazy about TV and use it more for noise than programming. They could take all the channels off my TV but BBC and Bravo, drop my rates a touch, and I'd be happy.

Those kids names feel wrong, but that doesn't mean they are wrong in the interpretation of the US Constitution. Honestly, I doubt those that penned the original document had any of the same interpretation of their rights as we do of ours today. You have to wonder where exactly does a freedom of speech begin and end. Words are just words after all, and what may be offense to me may not be offensive to those around me. We have words that are considered profanity, why can't we add names to the list of profanity and unacceptable language in society? I'm a parent, and I thought about my son's name for a long time before I settled on it. I wanted a good, solid, traditional name. He was my boy alone so there wasn't any competition from his donor when I was selecting his name. I settled on Matthew John. The least of my concern was how common the names are. I wanted names that meant something to me, and both of them do. More importantly, I wanted my child to have a shot at a very normal experience at school. A Matthew has a far less chance of being harassed and beaten up than an Adolph Hitler. Most of the parents I know feel the safety and well-being of their children is paramount to anything else in life. I'd be willing to wager these kids are in for butt-kicking after butt-kicking in school and the parents are to blame. They might never lay a hand to them, but the gave the entire population of any school those kids attend a BIG reason to single those kids out. Is there such a thing as abuse by proxy? If not, they invented it when they named those kids.

That's a sh***y situation. Being a big fan of hearts, I felt bad just reading your story. Was an actual cardiologist consulted? I saw you say CCU, but I didn't understand what staff was actual involved in determining disposition for the patient. I've only seen a few cath lab tables, but I'm fairly certain they would be able to hold a person of that size. I would think the biggest issue would be actual fear of doing anything versus doing nothing. If they attempt to balloon the guy, giving his size, they might be thinking that he will surely arrest mid-procedure. If they let him go, he may damage a great deal of heart muscle but be less likely to arrest at their hands. It's complete BS, and if I ever reached my dream of being a cardiologist, I would give the guy a chance in the cath lab. Although he's morbidly obese, he's 31. If for nothing else, his age may be the only thing that would get him through this. I would also cover my hind end by explaining to this poor fellow that he has a snowballs chance in hell of surviving this event with the help of the cath lab and probable stent placement, and even less of a chance without. I guess I'm like a lot of paramedics, nurses, and hopefully doctors. I want to do everything to save a patient that might be saved. I can sympathize with you though as I've had to stand by and watch people fiddle their bums while patients are in the active process of dying rapidly. There is a good thing to come out of this experience... You know you still care about your job and your patients. You have still have something a lot of people no longer have (if they ever had it to begin with).

My Mom's family was a hard-working, simple, farming type people from southern PA. They used a lot of the home remedies I've read here. The worst home remedy I've ever encountered was done to me when I was a small child by my maternal grandmother. Somehow I had gotten into some poison ivy playing in their yard, and I came in with a gigantic rash covering my entire leg. I was miserable. I was really miserable when my Gram got out the white vinegar and salt. She rubbed that stuff on my leg, and I swore I was on fire. After a lot of bawling and some home-made, hand-churned vanilla ice cream, I settled down and finally went to sleep smelling like a boardwalk fry. I woke up the next morning, still smelly, but nearly healed of the rash. Sometimes old people are really smart. The strangest call I've run involving a home remedy was last summer when I was called because the patient had a ringing in their ears. I get on scene to find this somewhat slow older female that stated she had put a metal earring back inside her ear canal and has been unsuccessful getting it out. She said some old man she plays bingo with told her to put a small piece of metal in her ear to stop the ringing. She also told us that she had this ringing sensation for over 20 years. Anyway, after she tried it, she said the ringing was worse, and that her ear was sore. She used keys, scissors, tweezers, and toothpicks to get the earring back out and all she managed to do was bloody up her ear canal. I didn't have the right equipment to even see well down her ear, especially after she had torn up the soft tissue. I ended up transporting her to the ER. By dumb luck the on-call ENT was down in the ER seeing another patient when we arrived. I'm pretty sure the patient was discharged before we were even back in service.

This is a fun little ironic topic for me to stumble upon. I hear constant complaining from the paramedics where I work about how bad the ER staff treat them. They go on about how rude the Doctors are, and how some of them have even thrown things at them before. Now that I work full time in an ER, it's easy for me to understand why the staff treat these particular paramedics poorly. I don't have problems with Doctors when I work as a paramedic. I've actually inadvertently impressed a few of them. Little things like obtaining a 12-lead prior to attempting conversion of SVT, printing during conversion, and obtaining a post-conversion 12-lead seem to go over really well with them. They also like it when you request to terminate a futile resuscitation effort instead of clogging up staff and a bed with a patient that has no chance in China, while they have a waiting room full of patients that can be helped. That type of thinking really goes over well in this area. I came from a different system. I have a college background, and went through an intense paramedic program. They have a six-month academy for paramedic in this system. It's yet another argument for education and against parapuppy mills. Incidentally, my husband reports he has no problems with physicians in this area either. He is also a college graduate. Coincidence? :-k

I take offense to people that worked half (or less) as hard as I have but feel they are just as important. I take offense to having an intermediate taking care of my family because the county didn't feel they needed to spend the money to hire actual paramedics with actual college educations. I really take offense to this "oh, whoa is me" attitude so many people have when it comes to education. "Maybe you had the ability to go to college and take all those classes, but I can't." That's total BS. There is no "can't." There is only "won't." If you want something bad enough, you find a way to make it happen, period. Plenty of us have worked hard to find a way through college. Maryland has the capability to rid itself of the demon that is the academy half a medic program. It has several community colleges that offer a paramedic degree, and one fantastic university that offers even more. I hope this proposed Board of Paramedics can facilitate advancement of the paramedic through educational requirements, competency requirements, constant review and advancement of the scope of practice.

I hope this becomes a positive move in the advancement of the paramedic level in Maryland. I honestly do not care for MIEMSS, nor do I care for Dr. Alcorta, or Dr. Bass. The protocols are also a big problem in that state. Before I moved, I began to notice a trend of declining paramedic programs outside of colleges. I rarely saw any county level fire based classes being discussed or planned. The colleges required certain general education classes to be completed along with the paramedic courses. I've worked with the night class, volunteer fireman paramedic and the college paramedic. Of course, the college paramedic could outshine any one of the cook-book medics. It's amazing how much a little A & P and English Composition can do for you. I also noticed most of those county programs were being replaced with the new EMT-I/99 program. If you look at the MD EMS protocols, the EMT-I, with it's 300 hours of training, can do nearly everything a and actual paramedic can do. They may have to consult more, but the fact that they can do the procedures and administer the drugs at all makes my blood boil. EMT-I was the easy way out of having a shortage of college educated paramedics. The even call themselves paramedics, not intermediates. Three hundred class hours and a few hours of ride time, and they feel they are "paramedics." Could they push their system back into the dark ages any faster? I'd love to see a board of paramedics, but only if they do the right thing for the paramedics that have taking the time and busted their butts to become a well-rounded paramedic with a degree. I'd like to see paramedic go from a certification to an actual license. I'd love to see more advanced protocols in place for those that fulfill the requirements to become a licensed paramedic, which would be especially useful in the more remote areas of Western MD where they have a little more extended transport time. (It might also be useful in PG or Montgomery County when they're fighting a losing battle on the DC beltway.) I'd love to see RSI, CPAP, and actual STEMI recognition programs in place that allow the paramedic to call out a cardiac alert to have cath lab staff in place when they arrive at a receiving hospital. Give them a chance to truly become an extension of the hospitals. Some of the smartest paramedics I know live and work in Maryland, it's about time they get what's due to them.

I'm not a big fan of slang. I occasionally use it when talking to my husband, but I NEVER use it at work, especially if I'm giving a report on a patient. I field a lot of the radio reports at my ER, and outside of slang, my biggest pet peeve is the use of the word "amp" to describe a medication dose. What exactly is an amp? Perhaps my definition of an amp is different than your definition of amp. My guitar has an amp, I certainly hope you aren't using that to administer D50W. In this case, I understand that amp is short for ampule, but I feel it has no place being used explain the dose of a medication that was administered. After all, it's really not that hard to say "Administered 25 mg of Dextrose IV..." It's one additional syllable. D50W doesn't even come packed in anything that could be remotely described as an ampule. Slang serves two purposes. It lets people be lazy when verbally communicating with other people and it creates confusion should the slang term become lost in translation.

No, but... I do live by the motto "it's easier to ask forgiveness than permission." For instance, I came from a system that required very little online medical control. There was a rigorous educational program, and immense standards to live up to. If we couldn't explain, in full physiological detail, why we did or didn't do something, we were gifted with unemployment. We carried three times the drugs I currently have, and had many more procedures at our disposal. There was no such thing as a "cook-book" medic there, and most of the trucks were double paramedic. Now I work for a service where I can't even push morphine on a STEMI without calling medical control. I have permission to give one dose of albuterol/atrovent and I am required to call for additional doses. I have been guilty of playing cowboy on a handful of calls here. I am guilty of refusing to follow the standard protocol for chest pain when I refused to administer 400 mcg worth of NTG to a patient with an inferior STEMI even though he had a decent BP the first two times I took it. (Notice I said first two, he bottomed out without my help and coded shortly after in the ER). I was called on the carpet for it by our QA person, and subsequently exonerated by the ER doc that received my patient. It was a judgment call, based on knowledge and experience, that I knew I could back up. I documented the treatment of the patient exactly how it took place. I am not in the business of harming patients, period. I would never attempt to conceal anything, whether I did it on purpose or made a mistake. Everyone has made at least one mistake and everyone has the responsibility to own up to their mistakes. If you don't, you're a coward.

Here's your real-life example. I was educated by Bob Page. Although I no longer work at St. John's, I will ALLWAYS be a St. John's Paramedic. I had a 48 year old male patient develop chest pain while mowing his lawn. His wife activated 911. The patient got a 12-lead within 2 minutes of arriving on scene that showed a HUGE anteroseptal with lateral involvement STEMI with reciprocal depression. He was loaded into the ambulance and en route to the ER within 10 minutes on scene. A cardiac alert was called. Transport time was less than five minutes. The patient remained in the ER long enough for orders and placement of the cath lab team, which took less than 5 minutes. He wouldn't have been in the ER that long, but apparently we moved much faster than the team. The patient was discharged three days later with three stents to a very grateful wife. Pre-hospital 12-lead and the ability to rapidly interpret and quickly move with this patient saved his life, not a doubt in my mind, and not a doubt in the cardiologists mind. There were other factors in this save, however I doubt it would have been possible without the above. The service I moonlight with has intermittent 12-lead capabilities. The medics do not know how to read a 12-lead, and all the area ER docs know this. Couple that with not being able to transmit, and it doesn't matter what the ECG says, the ER will do it's own workup, often costing the patient more than 20 minutes in valuable muscle. I'm pretty lucky, most of the nurses taking my report know me, and they know that if I say a patient is having an acute MI, they are the real deal. If I transport to the hospital I work at, I get what I need in rapid fashion. With that being said, 12-leads are only useful if the paramedics are educated and able to interpret them and initiate a rapid transport with correct treatments. NTG shouldn't be given in a 400 mcg dose if the patient is having an inferior AMI. They should be dosed with a drip that can be titrated to effect and blood pressure. Unfortunately, I doubt more than a handful of medics in my current know that. Blood pressure is like a toilet, once you start flushing, it's damn near impossible to push the water back up into the bowl. Quality education equals the ability to become more progressive providers. Funnily enough, I was talking to one of the nurses at work today about education. I told her that if I ever had a heart attack, I'd hope to God I was in Springfield, MO when it happens.

St. John's Hospital doesn't hire basics anymore. They haven't hired them in years, with one exception, and that is to staff their transport truck. They have been slowly phasing out the basic and going to double medic trucks. They are VERY pro education, and strive to be the best extension of the ER they can be. They're probably the best of the best in EMS in southwest Missouri. They pay new paramedics around 12.50/hour, but there is a catch. If you were not educated in the St. John/SBU paramedic course, you are required to successfully pass a refresher taught by Bob Page. You also have roughly 90 days of a field training officer pointing out every mistake you make and belittling you into submission. That's how they work, they break you down so they can build you up. If you have any crappy habits, you won't when you're finished orientation there. Those guys earn every bit of their arrogance, and there isn't one ER doc at the hospital that would say otherwise. The service we are talking about isn't as hard core as St. John's. It's more a who you know type of place. They're also not really actively interested in any basics. They're trying to create double medic trucks as well. They got a new medical director a few years ago, and he's been weeding through the current medics, and eliminating anyone that doesn't cut it. You have to understand, these services carry a lot of drugs. St. John's carries RSI drugs and thrombolytics. You just don't hand out paralytics to just any paramedic with a card. There is a lot of intensive education that goes along with the privilege of having so many options. The pay doesn't match the intensity. But, there are A LOT of paramedics working as garbage men in southwestern Missouri. Supply and demand. Oh, and rid, I'm not leaving EMS because I think nursing is the goose that laid the golden egg. I'm not giving up my paramedic. My interests have changed. Because of my experience with St. John's, I'm diehard on cardiology. I LOVE LOVE LOVE it. I want to continue being a paramedic with a critical care team. I would also love to be a cath lab nurse. It's not about money, it's about passion. My passion has shifted from straight EMS to cardiac. I've always wanted to do something great, and now that I've found my niche, I might just be able to now.

Vent, if I were a dude, I'd wanna marry you. 8) I can't even add to this, it nicely sums up every idea I had when I read the original post. Sadly, this sounds like something someone would do at the service I still moonlight for. I'd think if they needed a patent airway bad enough that they required intubation, then they would require supportive ventilation. If they were an alcoholic, and not just a social party drunk, I'd be concerned with a blind intubation attempt, and probably would have tried a less invasive adjunct and some supportive BVM. Just let that tube travel the esophagus and bust a varicies, and it's curtains. Let's also remember that intubation, nasal or oral, introduces an easy route for infection in the lungs. There is nothing wrong with BLS airway adjuncts, and they work well with patients that are teetering on the brink of needing a full intubation, especially if RSI isn't an option. Since your service doesn't have capnography capabilities, there is no real way to know how well the patient is ventilating. SPO2 readings are a vital sign, but a patient can maintain a good reading a lot longer than you might think. EtCO2 readings are nearly instant, which is one reason they are so useful in cardiac arrest situations. It just sounds like a fishy story, period.

I'm going to give you the same speech I got from my nurse manager Friday when I was brought in for a meeting (on my friggin day off). "I can't teach you to be a certain way. You have to figure out how people perceive you, and how you can change that perception. You should come up with an action plan. You might want to confide in a nurse that you trust, and just ask them to gently let you know when you might be giving off an impression to those around you that you don't necessarily mean to give off. I know how you paramedics are, I'm married to one. Blah, blah, blah..." I thought it was a little bit of nonsense, but maybe it would help you. I know what you're going through. No matter what I do, I come off wrong to people. Honestly, I have no idea how to fix it. I even have to come up with an "action plan" of how to fix my impression on people. Unlike you, I was accused of not being sympathetic to patients and not conveying the message that I care about their emergency. You were taken the complete opposite of me, being a know it all, and maybe too compassionate about your patient. Incidently, I am compassionate. I do, however, have a pretty low BS tolerance. It doesn't work well in a ghetto. I'll get to the point. I work every weekend, and one day during the week. The weekend team is my team. We get along great. No admin around, we have a good time, and we take great care of our patients. I trust them, so I enlisted their help. I told several of them about my reprimand. They couldn't believe it. One of the nurses looked at me and said she knew why I came off that I didn't care. I don't get excited. That's it. I don't get excited, I'm very matter of fact, and I pay attention to making sure the patient that needs the most help gets it first. Apparently, it really upsets patients that are complaining of having a cough when an elderly lady with obvious respiratory distress and chest pain go back ahead of them. Who knew. :roll: I don't know how new you are at your job. Perhaps there is someone there you can confide in that can help you with whatever behavior is causing you problems with people. You might even be able to talk to this instructor (outside of a call) about this problem. The fact that you want to be proactive should portray how seriously you take yourself and your job. If this guy, who I assume is pretty high up on the company food chain, won't help you, well, he probably sucks. If that's the case, then it's probably a no win situation. That's okay as well. Sometimes you just don't fit in with an organization. The deal is, you're bright as all get out. You can hold conversations with the best of the paramedics here, and we all respect you because of your dedication to continued learning (and your grammar ). You're also a chick, and it's sometimes pretty hard to be a chick with a brain. You remind me of a lot of the gals here, sometimes we are just too damn smart for our own good. You're going to find your groove, it just might not be with this job. It probably won't be as an EMT. You're bound for greatness grasshopper, and it might be your greatness that gives you your groove.

I worked for them for six months. I worked a rural station and was paid for 16 of the 24, unless I was up during the night. I got time and a half, if I was up for 3 or more of the 8, I got the entire night at time and a half. I rarely got the entire night. I took that pay because it was the only paramedic job in the area. I could only get a PRN status at the other hospital, their medic turn-over was unbelievably low, and the wages were only $2/hr higher. I have since relocated, and started nursing school. It was a kick in the nuts. It was a paycheck to paycheck lifestyle. The cost of living isn't bad in the Springfield, MO area, but I'm originally from Baltimore, so I'm sure my idea of high cost of living is different. Seriously, if I have to live hand to mouth, either my pay or my cost of living is screwed up.

If it's Cox Health or St. Johns, I can tell you anything you want to know about it. Seeing as how you said it was a LARGE southern Missouri hospital, I'd bet it would have to be one of them.

The OP posted a link to the pants he was talking about. Apparently, you do NOT have the same pants. No offense, but I only need two pockets in my pants, one for my wallet and a pair of gloves and one for my keys. I just see no need to have all those pockets. I really see no need to have kneepads, but I've never been a company person, and will never be a supervisor.

3" cloth tape works well in place of straps. You probably do NOT want to know how I know that.

Have you looked? Those are some fugly pants. What's with all those straps on the pockets, and some other strap on the right side? Do you need pockets down on your ankles? Seriously, there will be some less then slim whackers running out and buying these pants. Tempt them with pockets they can only reach when their trousers are off? It's very cruel to taunt a fat guy. :twisted:

Last year I got screwed into working 48 hour holidays in a busy metro station because I was new to this particular company. I think I got a total of 3 hours of sleep that entire time, and it was a crappy three hours. I began seeking alternative employment after that. I'm not interested in risking my life for a job anymore, especially when a company has so little regard for the safety of its employees that it allows such scheduling. I believe you should be allowed to sleep when you can if you work longer than a 12 hour shift. If your house chores are finished, napping should be fair game, period. It's really often the case with rural EMS areas that you don't run a thing until 9pm and you're up all night. Then you get to come home and waste your entire first day off sleeping because you're exhausted. And people wonder why the burn out rate is so high in EMS. Hummmm...