mikeymedic1984

Agree with the above; go straight to Paramedic school, there will be some agencies that can hire you as a non-driving medic. If you need to go to work now, consider CNA school -- that will get you in healthcare without the driving issues.

1. How would you rate how your were treated -- 1-10 ? If transported: 1. Were all treatments and decisions explained to you ? 2. Were you comfortable as a patient as far as comfort, privacy, and treatment decisions ? 3. How was the bedside manner ? If not transported: 1. Did the medics offer to transport you, or did they talk you out of transport for whatever reason ? 2. Were you given clear instructions as to what your next step should be (see privated doctor, go to ER, other advice) ? 3. If you went to the hospital/ER after EMS contact, were you admitted to the hospital or diagnosed with something different than what EMS suggested you had ? Regardless: 1. Would you call EMS again 2. What suggestions would you have for improvement ?

Glad you are better. Your story begs this question though : Do you remember actually getting bit ? I read a study where most "spider bites" are actually misdiagnosed MRSA sores. Since they look identical, and you typically treat both with the same antibiotics, the bite / sore eventually heals, so there is no follow-up to know which one it really was. But since you had it in so many different parts of the body, I just wondered if you really had MRSA that spread. Doesn't matter now, here is a link to what I am referring too, but is not the study that I read (think CDC publication): http://patients.about.com/od/Blog/fl/Is-It-a-Spider-Bite-Or-Is-It-MRSA.htm

If I said you would not face some discrimination because of your age, I would be lying, especially if the EMS Director is under 30 years of age. Many Fire Departments have an unspoken or spoken maximum age (but they are dumb if they do). In the interview sell the highlights of why you would be a better hire, for instance: 1. No childcare issues as far as babysitting, or having to call out because the baby is sick. 2. Hopefully more mature. 3. Hopefully a clean driving record and more experience driving. 4. Hopefully you do not look like a frail 80 year old. 5. Hopefully you will not make the dumb mistakes young'uns do, like get a DUI, cause a sexual harassment claim, or call out because someone is throwing a kegger or your favorite band is in town. I would much rather hire you than a big boobed 21 year old female, but I am the exception, not the rule. If you do find you are not getting the calls for interview, talk to the Director about doing some volunteer third-ride time "to keep your skills up" -- if you are not a jerk, once you make friends with some of the crews you will increase your chances significantly --- it is who you know, not what you know.

You can not force someone in most areas of the US. The police, a judge, or a Doctor can force someone to get a psychiatric evaluation if they are a threat to themselves or others, but an EMT/medic can't. Nor can the police, a judge, or a doctor force someone to have an operation or care (other than psych) if the patient is competent and refuses.

If you have "chronic pain issues", your regular doctor should have you covered for that. Typically, drug seekers with "chronic" conditions call EMS on Fri/Sat/Sun, because they can say their doctors office is closed, so they can only get meds from the ER ------------ BS ! If I have a chronic pain condition, you can believe that I would not run out of meds. I would go to my Doctor, before I am close to running out. It is funny that no man ever has the need to go to the ER for his Viagra. They seem to always have enough to get through the weekend. If you have failed to get the meds you need, then shame on you. If you are close to running out, you can call your doctor for a refill -- funny how chronic pain patients never seem to run out of meds during office hours.

Ok chbare, it is late July -- how many times have you administered pain medication this year (not including chest pain) ?????? Be honest. And I am sorry, it is not possible to be in "10-10" SCALE PAIN and not have elevated vital signs. You can have some pain, without elevation, but you cant convince me that you are having the WORST pain of your life with vital signs of 110/60. 64, 16. If I can wait 30 minutes on my pizza, I can wait 20 on pain meds, especially for a chronic condition.

I did see a service that had their pillows "cabled" to the head of the stretcher. It had a gromet hole in one corner of the pillow and enough cable attached so that they could put the pillow under the head of the stretcher if they had a back-boarded patient.

Why is EMS the wrong choice ? It is not your choice, it is his. Every career has its positives and negatives, and although I enjoyed working in a hospital environment, I would never want to be a Nurse. Call me a homophobe, but holding another man's penis is just not for me -- nor is wiping buts, or not being able to fart unless the "doctor" says I can. I like the autonomy and unpredictability of EMS. Do I wish it paid more and had better benefits ? Sure I do. But that is not all that is important in life. How many nurses do you know that have been in the field for more than 5 years that LOVE their job ? Yes there are some, but I have found that the percentages of Nurses and Doctors who hate their job is about the same as it is for our industry. As the old saying goes, "do what you love", and you will never "work" a day in your life. There is nothing worse than being stuck in a job (any job) that you hate. Teach him to live within his means (budget wise, whether he makes $10k/year or $ 200k/year) and let him do what he loves, regardless of what that job is.

I am not discounting the need for "pain management", but I imagine you will get the "death stare" from some medics if you call them routinely. There are too many drug adicts that always state their pain is a "10" out of 10, when they are sitting there calm and collected with average vital signs. Assuming you have a decent nose for sniffing out the "seekers", you then have to make sure you are utilizing your resources for "all of your service's patients", not just your patient. For example: 1.You are 20 minutes from the hospital and you have a "10 out of 10" patient, and then choose to take the last ALS ambulance out of service to come to your call; and then you wait on their response to scene, give report, and then do whatever you have to do to turn the patient over from your care, then that is stupid as you could have already been at the ER. There may be other patients who needed that ALS resource more (MI, Cardiac Arrest, a patient in greater pain, etc....) 2. Is your available pain meds on the ambulance the most appropriate med for the condition ? I hope you are not giving morphine to all migraine patients; you should have some lower level meds available like Toradol or Fentanyl (even Motrin/Tylenol for that matter). Just because you have narcs on board does not mean that you have the best med for a particular illness/injury. 3. Unless it is an injury that just occured, most "pain patients" have been in pain for hours, days, or weeks. Another 20 minutes of waiting will not kill them. Conversely, if your ALS units started calling you to their scenes to transport every patient that they find does not need ALS, would you be cool with that ?

I have been doing this a long time, and I have yet to need a gun (and yes I have worked urban 911 in the hood). Guns do not always save police officers, and many times when those officers (who train with guns all of the time) are in a shoot-out, they miss their target (even when standing less than 10 foot from the perp). How would you feel if in a moment of fear you unloaded 15 bullets in the generic area of the bad guy, and hit innocent people in the neighboring apartment / street / scene ? I am sure there are some dead medics out there somewhere that could have used a gun, but you have a much greater chance of dying in an ambulance crash than you do from being assaulted.

me: When was your last menstral cycle patient: I am not a woman.

As the new guy, you must first realize that you do not know squat. You have "book/class-room knowledge", you do not have "real knowledge". This is not to say you should not speak up if someone is obviously killing a patient, but for you to think you are smarter than those who have done the job for years is an arrogant position at best. Watch and learn, get your street smarts, and then offer your opinion. But even then, I always offer suggestions; I try not to dictate orders unless someone is obviously lost -- in which case they are usually grateful to get the monkey off of their back.

It is pretty hard to overdose a patient in the EMS field, unless you leave the Dopamine or Lidocaine drip running wide open. With that being said, it is still possible to have dosing errors, or wrong medication errors due to packaging being similar. For years in the hospital world, there was Heparin overdoses because all heparin was in the same colored/sized/shaped/labeled vial, regardless of concentration. They finally changed that. In the ems field it is good to someway deliniate or move "like colored" vials and boxes away from each other --- Albuterol and Atrovent for instance. Does your Benadryl vials look like your Vasopresin vials --- but as always, if you do the 5 "R's", you should not have these problems. P.S. if you do have two vials of medicine that are very similar in appearance or color of packaging -- switch to another manufacturer for one, or change what you order (if in a vial, can you get it in an ampule or bristojet) ? Can you package it in another package of your own (fishing tackle or pill bottle container) to separate it from it's similar friend ? The most dangerous error is probably going to be drips, due to the lack of IVpumps on the truck. If your service is too poor to buy pumps, at least purchase dial-a-flow tubing so that you can be somewhat accurate in your dosing. Think about it, if your 14 month old child was being placed on a Dopamine drip, and the nurse just wanted to eyeball the drip rate and not use a pump, would you be cool with that ??????

First and foremost, this was hypertension by the textbook definition. If you visited your doctor for a routine physical and had that blood pressure, they would probably start you on a treatment plan. With that being said: 1) Many Americans walk around with a blood pressure in this range on a daily basis --- that blood pressure in itself is not considred a crisis. It is possible that the medic you encountered suffers from HTN and may have had a pressure in this range on any given day. 2) When you are in pain, it is not uncommon for your pulse rate and your blood pressure to increase. You can use that as a barometer (with other factors) to determine if someone is really in pain or faking ----- "Doctor, my back pain is a 10/10, the worst pain I have ever had !!!!" (B/P 120/64, with a pulse of 62 ------ Not likely). So, if the pt has no hx of HTN, her B/P may have just been temporarily inflated by her current illness/pain. 3) There are many more medical issues that can cause a blood pressure to be in this range, so you have to look at the whole picture and not just focus on the blood pressure alone. I would expect that many dialysis patients would have a pressure that is near this range a few hours before they receive their dialysis treatment. I would expect that someone who is morbidly obese might have this blood pressure without any other symptoms.

Excuse me for my error if it exists -- but I believe the Physician based ambulance team for Princess Diana sat on the scene with her dying body for at least 45 minutes -- maybe an hour, instead of using the golden hour rule of getting to a trauma center. I am not saying she would have survived her injuries, but i am guessing that her odds would have been dramatically increased had she got to an O.R. 30 minutes earlier. Again, with the limited diagnostic resources available in an ambulance, a Physician is not any better than a Paramedic, unless you just need sutures or a prescription. http://www.coverups.com/princess-diana-death/princess-di-french.htm It seems my estimated on scene times were a bit underestimated !!!!! Google for yourself.

In the hopes that this was a legitimate post, let me clarify for all parties. NO HEALTHCARE ANYWHERE IN THE WORLD IS "FREE". Someone either pays for it through high taxes (up to 40-50% of your income in some European models), through insurance company premiums, or you pay for elective care out of pocket. In the US, the haves pay for the have nots through taxes (medicaid) and increased insurance premiums because hospitals can not turn a patient away due to lack of funds (therefore, my BCBS insurance premiums are higher because hospitals charge an increased rate to insurance companies to make up the loss they incur from the uninsured). As far as the affect on 911 call volume, those who are homeless/uninsured or are on Medicaid have no out of pocket expense for ambulance service, regardless of what we charge after the fact, so there is no reason not to call 10 times per day if you wish. Also note, that under the US EMS model, most services can only bill for an actual transport, not being called to the scene (although some have tried to charge a response fee); so you can call an ambulance to your home 20 times per day, but would not incur a charge unless you were actually transported to the hospital. But again that bill is sent to you days/weeks/months AFTER you are transported. For all those who chide the American healthcare system, we sure see alot of Canadians who choose US Healthcare over their "free" national healthcare: In 2013, 41,838 Canadians went outside the country to get medical treatment, down from 42,173 people leaving the country in 2012. This is interesting since wait times for patients who had consulted with a specialist till the time they got actual treatment increased from 9.3 weeks in 2012 to 9.6 weeks in 2013. Read more: http://dailycaller.com/2014/01/16/report-tens-of-thousands-fled-socialized-canadian-medicine-in-2013/#ixzz37MF0rg4C

No offense, but ask Princess Diana of Wales how her "physician ambulance trip" went. I really do not see the advantage of doctors on a transport ambulance. I can see the advantage of a first-responder house-call type of setup, if the physician had the ability to do mobile labs and xrays.

P.S.: I am sure i know what you meant by: "I have noticed (especially yesterday during shift) that I have been more irritable easily offended or too critical of my partners. Luckily I have not been this way with my patients but from what I have read that seems to be the next step I dont want that. I have always wanted to do my best and do things as by the book as I can." But just in case I should have interpreted it directly as you typed it: No matter what kind of day you are having, you do not have the right to take it out on your partner(s). And yes, your patients can tell by your body language and facial expressions when you are having a bad day, even though you are not "impolite" --- just as you can, when you encounter those people in your life. The good news is you noticed this all on your own without having it expressed to you in a manager's meeting where your behavior is being documented. Take a vacation.

"I work all the time but I try to take off a weekend here or there to get a break." I am not sure how many hours per week or month that equates to in your world, but I have always said, "You could get a job having sex for 100 hours per week, and you know what; after a few weeks you would get tired of having sex". Dont do EMS any more than the 40-56 hours per week, that is a normal schedule. And take a vacation at least yearly; even if you do not go anywhere, take a week off from work. If you need more hours to make ends meet, do something else part-time.

I have been doing this for a long time and I have never seen a COPD pt's hypoxic drive knocked out by O2, probably because I have always administered the right amount. With that being said, would you rather have a critical pt with a sat of 72% or 92%, regardless of how they got critical ? I just picked up an elderly pt who was satting around 80% on room last week, but was talking and did not look like an 80 percenter; with 4L of O2 and repositioning, she was in the 90s in no time. As with any treatment, it needs to be titrated to the patient at-hand, not dosed out as the cookbook dictates. Not everyone with a low sat needs high-flow O2, but those who need high-flow O2 should not have it withheld because of an irrational fear of the CO2 boogeyman.

I will bite !!!. First of all the supreme court did not rule that corporations do not have to pay for birth control. In the hobby lobby case, HL had always paid for 16 of the possible 20 birth control options for women (note that no insurance company pays for condoms for men, that I am aware of). Obamacare would have forced them to pay for the other 4, which HL saw as an abortion, and they felt that was morally wrong, and did not want to pay for it. The supreme court ruled that they did not have to pay for what they saw as an abortion. As a female employee of HL, you can still get any form of birth control that you want except for those 4 and have it paid for by insurance, but you can also still get those 4 if you are willing to pay out of pocket; so your birth control has not been banned, it is just a matter of who pays for it As far as viagra for men, many men who are on it are on it because they have to take HBP meds which make them impotent. I would thing that if you hate little pee-pees, you definitely would not want a flacid one.

Be careful with grants. Yes, you can find free money, but it usually comes with a whole lot of paperwork strings that can be a hassle. You may do just as well to find a good used vehicle or find a dealership that may donate a trade-in to you or give you a great discount. as long as you put a sign on it that says "donated by the good folks at ABC ATV, Golf Cart, or Jeep Dealership"

I have not bought one of these, but before you buy find out where the neareast authorized service dealer is that can do repairs. I live in a major city and there is only one dealership that can work on them within 200miles. The good is that the room and gas savings are huge -- a local private ambulance service provider in our area boasted that they would save over $2 million in fuel costs by swapping over. The bad is that I am told that most parts have to come from Germany, so when your vehicle breaks down, it will be down for weeks, not days. And as mentioned, if you live in a remote area, your nearest service dealership may be in another state. The salesman's counter to this question was "how many broken down FedEx trucks have you seen on the side of the road" (claiming they rarely break down) ?"

Not there, but dont leave huntsville without getting a "kitchen sink sandwich" at Stanlieos: http://stanlieossubs.com/ PS: Dont be shocked by the low wages in the southeast, but note the cost of living as well --- what is a $300k shack in California is a mansion in the southeast. I sold my $110k house to a couple from CA a few years ago, they could not believe they were getting a 3k sqft house for that price. Also make sure you stop and eat at Chickfila and Waffle House.