mikeymedic1984

Unfortunately the real truth is that all things are driven by insurance company reimbursement (yes it sucks, but its true). Ambulance services can not get reimbursed any further on the transport if you are a Doctor or a Dog Catcher, so there is no reason to spend the extra big $$$ on you; when there is no reimbursement model for doing so. There is no reason to put you on the ambulance unless you agree to Paramedic pay. It would be like offerring MRI Scans on the ambulance, if you cant get reimbursed from the insurance companies, there is no reason to endure the expense.

You can call Nurse Ratchett and Dr. Bombay for all I care, I just hate to see the site die................................ any suggestions ??????????

Well, all I can say is this site is coding --- somebody call Rampart and get some orders for some D5W TKO and two rounds of intracardiac EPI from Dr. Early and Dixie.

I can hear the crickets chirping up in here, where is everyone at ?? Do we need to introduce a sex topic or what ???? Hell, where is crotchity or hatelittlepeepees ????

I am guessing their cell phone ..................................................................

Guess he is gone, but it is a fair question that newbies might need an answer too. 1. Question your own bedside manner first, if this is a common occurrence, maybe you have an issue. We had a smart ass yankee who nearly got his ass whipped every time he went in the hood, i went in the same hood and never had a problem. 2. Speak softly if the person is enraged. If you speak quietly, they have to stop their rage and attempt to hear you. Often calms them down. 3. Play the "why me card" ! Dude, I am just here to help, why are you yelling at me, I have not a done a thing to you, and I am showing you respect, I would expect the same respect in return".

http://mdjonline.com/view/full_story/25124577/article-Bo-Pounds--To-friends-He-was-just--one-of-those-rare--rare-people-?instance=special%20_coverage_right_column This guy was pretty much the founding father of private EMS in the Atlanta area, and then grew Metro and Gold Cross Ambulance Services to cover most of North GA.

Guess you have never been dispatched to a shooting, that was not called in as a "shooting". I have. People do not always tell the truth when they call 911, or sometimes the caller does not know it is a shooting (ie..... person down at bus stop or side of the road, person unconscious in car or car accident where the driver was shot). With that being said, if you are not experienced in handling weapons, I would not handle it, unless you felt that someone was going to pick it up and shoot you with it. As mentioned, it is evidence of a crime, and should remain in place without tampering if possible; if you do, snap a picture with your phone before you move it, and then be prepared to go to court and testify.

Seems reasonable --- but I am not sure it is entirely necessary. I have always said (no I didnt make it up, I stole it from somewhere); patients do not die because medics do not intubate them, they die because medics do not VENTILATE them. I can't tell you how many times I have watched medics, especially helicopter medics, dig around in somebody's throat for far too long, trying to get them tubed. A good reminder is to always hold your own breath from the minute you remove supplemental oxygen or BVM and begin your intubation attempt until you are successful or fail. When you need to take a deep breath, chances are the patient needed two or three.

My state recently "clarified" their rules pertaining to another situation, but is relevant to this one. Dialysis ambulance services were not providing 24/7 coverage, and were only open during dialysis hours (and barely equiped as ambulances). The State clarified and stated that an ambulance is an ambulance and that there were no different rules for ambulances that did not do 911. Therefore any vehicle that is licensed as an ambulance must operate as such regardless of the type of call volume they handled. If your "standby" ambulance does not transport, then lose it, and come with bicycles and jump bags. But my guess is you need the vehicle to earn the $$$, therefore the vehicle should be licensed and staffed according to State rules and regs.

No. The EMT B program is similar to being a "patient tech" in the hospital. If you are serious about EMS, you must consider the EMT-A, immediately followed by getting into a Paramedic program. In other words, it is very similar or comparable to CNA to LPN to RN. EMTBs are CNAs -- and there are thousands of them because every fire department has pretty much mandated that you become an EMT B at minimum.

I am sorry to say what I am sure others are thinking, but will not say ....... if you need a tutor for the EMTB program, you are not cut out for this profession.

Please list "one" piece of equipment you used back in the day, that the youngsters have never seen --- or a piece of equipment you have today that you did not have when you started in EMS? I will list a few to get the ball rolling: 1. We had the Life-Pak 1 (no pacing or 12 Lead), weighed a ton. 2. No pediatric sized anything. 3. "M" sized oxygen tanks (i think tanks are sized differently today, but it was about 5 feet tall, and had to be lifted into and stored under the squad bench),

First let me say, those who say work out more, you do not know what you speak of. TECHNOLOGY IS GOOD. You should be glad that my generation did not take that attitude, because if we had, you would still be using the 2 man ferno stretcher. For those who have never seen or used the antique. You had to collapse the stretcher all the way to the ground, and then lift it into the ambulance (partners on each side). Imagine the joy of having a 6 foot 4 person, partnered with a 5 foot 2 person trying to lift a stretcher by the sides. Imagine lifting a 300 lb patient from the ground. Imagine having to lift the stretcher from the ground or low level at least 2-6 times on every call (put the pt on the stretcher, move the stretcher from home and down steps ---no stairchairs back then either --- lower at back of ambulance, lift into the ambulance, lift out of the ambulance to ground at ER, lift up to rolling position, raise or drop to meet the level of the ER bed (ER beds were not always hydralic back then either, most were a fixed height). The power pro is great, especially for a non-emergent transport service. It is heavier, but when you get a 300lb + patient, all you have to do is get the head of the stretcher in the truck, and then both partners move to the foot of the bed and do a two man lift into the truck --- same for unloading. We put battery chargers on our trucks, using the inverter, but you could just buy more batteries and let each crew take two batteries with them --- like all rechargable batteries, they lose life over time. I would caution you to lower the stretcher when rolling the patient (especially on uneven terrain). as the extra weight of the stretcher plus the weight of the patient create a high center of gravity if the bed is raised to its upmost level, which creates a greater chance of tipping the cot over if a wheel gets stuck or the patient moves too much. As Charleston Heston said, "You can have my power pro when you pry it from my cold dead hands" lol.

No matter how I type this, it will sound like a slap against EMT-Bs, but I promise it is not. As a student at any level you should be very nervous with your first patient encounters, as there are a ton of things that ARE NOT and CAN NOT be covered in a classroom. As you gain experience, you will become more confident. At the EMT-B level there is not a whole lot that you can screw up (in most States you are more or less the ambulance driver who will be paired with someone of a higher skill level, and experience level), unless you refuse to transport someone or wreck the truck, so realize that the chances of you being responsible for a patient's death is very remote unless you are totally irresponsible. Lastly, realize that for the most part (or at least I hope), we do not create the injury or illness that your patient is experiencing -- we are just there to manage it in the moment of crisis, and realize that patients die despite our's and the medical community's best efforts to not let that happen. We can not undo 20 years of smoking cigarettes or being 100 lbs overwieght; nor can we stop the drunk driver from hitting you or undo the damage for not wearing a seatbelt. Stick with your ABCDs, be a patient advocate, and do the best you can. There is a very good chance that you will make mistakes, but remember we do not have x-ray vision or the ability to confirm our diagnosis with lab results as doctors do. If you make a mistake, learn from it, and do not repeat it. I would also suggest "volunteering" as a tech in your local ER, where you will get the opportunity to see more patients, but not be in charge -- so you will gain valuable experience in just a few month's time, without the stress of being the 2 person crew that is in charge, in the field.

I hear you doc, and agree to a point. If I attended a KKK rally in uniform, and it was broadcast on the news, I would expect to be fired for embarrassing my company. But this was in the privacy of his home, and I believe in California, it is illegal to tape people without their knowledge. So I see it like a serial killer who was only found guilty after the police did an illegal search of his home; he would go free in the court of law, regardless of how guilty he was.

Ok, lets take race out of this. Lets say I got written up at work today by my supervisor. When I come home, I vent to my wife and/or girlfriend, in the privacy of my home. Without my knowledge OR CONSENT, she/they tape my tirade and put it on youtube. I walk into work tomorrow and I am fired for the things I said off of the clock. Do I have a case ? Also, it should be noted that all he really asked his girlfriend to do was to not embarass him with her friends and their activities. As wrong as it is, his generation does not believe in interracial dating (except for him personally LOL; although it is really not limited to his generation --- had it happen in my family recently, and the family of the african american family involved was far more upset about their son dating outside of his race, than us racist white people were --- go figure) ? Anyway, there should be some due-process for those we hate as much as we have for those we love. Freedom of Speech was not intended for those who say the things we want to hear, it is for those who say what we absolutely do not want to hear. And yes, I know Freedom of Speech only protects you from the government, not your employer, or the backlash you get from the public, but AGAIN, this man did not pick up a microphone and spew his filth -- he thought he was safe in his own home.

I hate to defend a racist, but I am shocked that no one is outraged by recent events. For those who do not follow sports, the owner of the NBA team the LA Clippers was recently embarassed by his "girlfriend" who taped him without his knowledge. In the tapes he makes some racist statements (without using the N word), in the privacy of his HOME. Somehow the tapes get leaked to TMZ, and then the world went crazy. Mr. Sterling has now been fired, and the NBA is trying to take his team (his business) away from him. Again, not trying to glorify this guy, as he is lower than pond-scum, but he was fired for comments he made in the privacy of his home, to someone he thought he could trust. He was not fired for anything he did in the workplace. He wasn't even given a hearing. Am I the only one who sees this as "Un-American" ?

Not trying to be rude --- it is probably me that is dumb, but what is your point ?????? I have no idea what you were trying to say or prove. You don't get respect, you earn respect. Are your co-workers being mean to you ????

It varies from hospital to hospital. As mentioned, some have their own EMS, some have specialty transport like Neo-nate, Pedicatric, or helicopter service. Most use medics as "techs", which may be able to do a lot or very little. I have been in settings where I acted as "Charge Nurse" to settings where I could just take vital signs or draw labs. That would be a question to ask during interview, but with that being said, any ER job will give you a lot of good experience as a newbie.

Just depends on your long term goals. I would recommend "A Degree" for anyone entering the field today, as your upward mobility will be weakend without one. A Paramedicine degree makes the most sense, but a degree in Health Care Management (or any generic business degree) may broaden your opportunities to work for other industries (medical and non-medical) besides EMS; for instance hospital management, although most department heads in a hospital need to be an RN, there are many departments and upper level management jobs that are not typically occupied by nurses. You never know how you might feel about EMS 20 years from now.

No, I wouldnt as the lowest setting on the IVENT is for 10kg, but you have to ask how many infant/ventilator patients did you transport last year ? If you had a significant amount, then consider it, but I am guessing most of us did not have any. In my area, the childrens hospitals and the major trauma center have pediatric and neonatal transport (not to mention helicopter ambulance service), so they handle these transports --- maybe i am lucky.

Just note that Rural Metro had to file bankruptsy last year to manage their debt. That bankruptsy may hurt them with many of their 911 contracts, if the municipalities put the right language in the contract. I would never work for either, regardless of which state they are in (I realize that outwest, you may have little choice), as they are solely driven by accountants and their KPI report, not by patient care.

Your age is more important -- if under 21, you will have trouble finding employment. Take a defensive driving course to shave some points off if you are over 21.

The Ivent is the only way to go, as it allows for everything. The autovents work, but does not allow you too many settings to choose from (rate and tidal volume only). In the 911 environment (post arrest) it is fine, but if doing interfacility transfers where a pt has already been on a real vent, the autovent sucks. So just depends on how you are going to use it, and how often. If you have short transport times, and are looking at 911 use, the old BVM may be a more cost effective tool to use. If you are shorthanded on arrest scenes, then the autovent is a good choice.