UMSTUDENT

Yeah, so if you're currently working "Grey's Anatomy" you should be extremely insulted as a paramedic, student or current EMS provider. Basically, this episode deals with an event called a "Code Black" by the hospital staff in which a an un-detonated RPG shell is found inside a patient on the operating table. A paramedic in the field has bravely inserted her hand in order to stop an internal bleed, but must keep her hand on the bleed in order to not detonate the bomb inside. A bomb squad has currently been called to the hospital and is assessing the situation... In the beginning of the episode, when the paramedic and surgical team enter into the OR, she makes the comment that she "doesn't have enough education to be in an OR" and feels uncomfortable with the situation (not currently knowing there is a bomb inside of the patient). This alone shows what people think of our profession.... Further into the episode the anesthesiologist take the time to show this paramedic how to bag a patient before jetting out because "he has kids." Basically, a medical doctor must be more important because he has kids and a medical degree. Wake-up for all of you out there who think people, especially TV show medical advisers, respect our profession.

The I-99 is used here in Maryland and is sometimes referred to by some people as "almost a paramedic." The CRT-I, or Cardiac Rescue Technician at the '99 level, is allowed to do many of the skills that a paramedic can, abit with more medical control and obviously less education. In some places it is a 9 month program that can be taught by one instructor, usually a paramedic with significant levels of experience. It is my understanding, however, that the National Registry is getting rid of the I-99 standard and switching back to the previous level of certification. Don't get me wrong, there are a lot of great "medics" out there, but it really is the very minimum education that can possibly be given in order to be an ALS provider. The idea in Maryland is that the CRT is a way to provide ALS to the more rural, and less densely populated parts of the state such as Western Maryland and the Eastern Shore.

Being a student myself at a fairly large university I can personally say that if it is at all possible, limit your work hours to a minimum. I go to school with many other students who are all attempting fairly high course loads (18-21 credits), many of them trying to go the pre-professional/pre-med route. Simply put, if you're trying to go for a 3.7 GPA I would say working is a dream. Most of the students I go to school with don't work at all, or very little, and only at jobs that allow them to make their own schedule. Depending on the type of school you're going to this will probably be assumed. Most professors could care less if you need to work to put food on the table, and will in turn assign work loads to accommodate the mass amounts of free time they expect of a professional student. I would say, depending on the rigor of the institution, up to 25-30 hours a week of studying may be expected per class. Not all classes are like this and it depends entirely on your aptitudes Depending on where you go to school, I think you'll also be surprised by the number of students who simply assume large amounts of debt. I know out-of-state students who, in order to succeed, will eventually be in $80,000 of debt and they accept this because...well it's kind of expected. Outside of this you either have kids on a full-ride or have their entire education paid for by their parents (more common than one might think). This is just for undergraduate. University, from what I've seen, has become more and more of a type of "experience" and right of passage that is expected by employers. The life skills learned in an institution of higher learning are really indispensable and the money is absolutely worth it. If you must work, I suggest finding a job that will let you work perdiem as some have suggested. Some people I know work for local private transports and make decent money working 20-25 hours a week. They don't call them poor college kids for nothing. A lot of the experience is how to live and entertain yourself on next to no money.

I recently read the article posted by Dust in the General News section about two Texas paramedics who refused to transport a patient to the hospital. I was wondering what the opinion of the people here was about patient refusals. Do you see something wrong with the ability to accept a refusal? Should paramedics be allowed to refuse transport to the hospital if they deem the complaint as non-emergent? If so, under what conditions? Should paramedics be given more skills in order to treat and release more patients? I was just wondering because it seems that everyone has a different opinion regarding refusals. Some people love them and some people hate them

"If you're in lead-2 you ain't got shit" Old parody of the Johnny Cochrain saying from the O.J trial. Heard a medic say it once.

Do any of you have any idea how inaccurate the human ear can be? Put 10 people together and they'll almost all tell you a different BP within a few torrs. My point is simply that if human beings can be slightly inaccurate, then why not use a machine that is sometimes slightly inaccurate. What is to say that you're more right than the machine? It's not about laziness, it's about efficiency. This is especially true in a profession that is exposed to a lifetime of high pitched sirens, road noise and screaming loved ones. After 20 years the machine is probably more accurate. I'm young and I can barely hear a BP on a rough road let alone some of you who've been doing it for the better part of two decades. Some of you were teenagers in the 80's and don't tell me you didn't have Walkmans either... After all, tell me the difference between a systolic of 176 and 180. Better yet, tell me the difference between 150 and 180. They're both hypertensive. What are you, as a medic, going to do for them? No matter how you look at blood pressures they are based on set standards. The difference between 82 and 80 is a radial pulse (and in my state, the ability to give vasodilators is 90), but how significant that is in terms of treatment given is based entirely on a set standard a group of people have decided upon. When a machine becomes highly inaccurate is when you have a significant problem. Of the machines I've had experience with most have been fairly accurate.

I've found that more rural departments tend to have the nicest things in turn of hardware depending on the style of service being implemented. For instance, in my area we have volunteer organizations running top of the line, totally customized ambulances from a variety of different manufactures. We're talking large medium-duty "mini squad" ambulances with little expense spared. Some of them also maintain, and operate, half-a-million dollar rescue squads. They also tend to have decent equipment in their units. I've also been impressed with the quality of provider that rural systems hire and maintain. Rural EMS, depending on your area, really depend on the quality of their providers because of the extended transport times to certain facilities. If they're third service oriented they also tend to attract people specifically interested in EMS, which in my opinion, is a huge plus. The only thing you might not find in some rural, volunteer services is a lack of respect for basic professional commodities. For instance, some stations may not provide uniforms of which can become extremely expensive. Turn-out gear can also be hard to come by if you're interested in pursuing a career in firefighting (cross-training is sometimes highly sought after due to the volunteer status of the community). Basically, simple things that are common place in a professional department may not be found in some rural areas because of a lack of fundling. I've found the experience to be wonderful, although sometimes stressful. Different issues for different places.

I myself am someone seeking a 4-year Bachelor of Science degree to become a Paramedic. I won't say where as I'm not here to get on a soap-box about quality of education, etc. My biggest point is that there are people out there, quite a few actually, who do seek a higher level of knowledge about their field. I go to school with people from all over the world who have come to obtain a very unique degree (Japan, Middle East, multiple regions of the U.S.). I've had to defend my choice of majors to almost everyone I've ever come in contact with. "Why didn't you go into nursing?" "Are you still looking at medical school?" "I'm not sure if I want you training in a profession with that much risk." I'm lucky I have people supporting me in my decision, especially because I believe there is a professional future for the field of EMS. I think a lot of the public health problems facing our nation could be solved by our "profession." It just requires more respect and more legitimacy among the "other" health professionals. I look forward to the day that more schools offer advanced degrees in EMS. It's unfortunate that so many of us have to get graduate degrees in "related" specialties to gain respect in the community. There should be Ph.D programs in our field... The fact of the matter is that most of this country sees paramedics as sub-professionals. That most likely won't stop happening until we can walk into people's homes as degree holding professionals. I personally believe that a minimum of an Associates degree should be required for a Paramedic and more Bachelor level programs should be started.