DwayneEMTP

If your ACLS class is like mine, you won't learn anything about the ACLS materials during the class, so make sure you know it going in. The ACLS class is all about CPR and team concepts. Having said that, I believe, though I don't remember exactly, out of 4-5 nurses and 7-8 medics (students), only 3 of us passed first time through...Though it didn't matter much. After 2 or 3 hours to study, they gave the same test again...with much better results. ACLS is all about algorithms. I didn't remember until the night before that we had the ACLS class the next day. I spent about 6 hours on book and passed the test with an 80 something... Know the algorythms and how to do CPR and the class is a breeze... Dwayne

What I've come to believe, having preceptored with two different services... If you find that you're a burden where you're at? Do whatever is necessary to ride with a different service. My first phase was a complete waste of time from a precepting point of view. I saw a lot of patients, but most everything I learned I learned on my own. In the service I'm riding with now, finishing my second phase this week, the attitude is completely different. In the service I'm with now, the preceptors choose to do so. I've bounced around a little because I started second phase near their normal shift bid, but each person I've precepted with has had the same goal. To push me until I begin to make mistakes, then celebrate my victories while identify those mistakes, teach me what I need to know to improve and/or give me homework relative to my weaknesses, and then push me some more. I'm expected to challenge their every decision, as they challenge mine (all in kindness and the spirit of learning). In the last month I've gained so much knowledge, and perhaps just as important, so much confidence! Each shift is as valuable as my best week of medic school...and I don't say that lightly. This preceptorship is too important to try to "survive" it. I wasted my first phase...and can never get it back. Make sure you milk this time for all it's worth. If you can't do that where you're at, demand that they put you someplace that you can. Your ambulance clinicals are not a gift. You've paid for them, you've earned them, demand that they are worth your investment of time. P.s. If it turns out that you do in fact just have a hinky attitude (Which I've not seen signs of here) then please ignore all I've said above... Dwayne

Yeah...you're all smug now... Don't force us to play the PMS card...we've got it, and aren't afraid to use it! :wink: Dwayne

Ah...got it. Thanks Rid.

That's why we love you best Jake! Dwayne

You'll think this is silly, but I'm completely serious. To calm down and think. I was able to proctor at a couple of NR skills tests. The thing that struck me over and over was that I saw these kids know their skill sheets to a T, but go to pieces when they had to test. Panic is not conducive to rational, logical thought. Being calm is a skill. It needs to be learned like any other skill. I told you you'd think it was silly... :wink: Dwayne

Is that a memory aid for something? Not being sarcastic, I just happen to love memory aids... :wink: Dwayne

Hell... Semantics are very important I believe...Thanks for the correction. Dwayne

There is one piece of equipment that I believe I would be completely different without. My current and future patients would certainly suffer if it was ever broken...my computer. I'm near finishing my degree in EMS...thanks to Dust. I'm committed to being a diagnostician first, with or without tools...Vent. I constantly review the physiology of the calls I run...in case I ever have to explain them to AZCEP... Realize that things are rarely as they seem at first blush...Asysin2leads... I am very much aware that there is a reason some medics are viewed poorly, and that I have the power to change that perception for myself....Any of the Docs... If ever I decide all basics are idiots I'm to refer to Dawn's Law... ("The" Wendy I mean, of course) And on and on. Of course all of these lessons over lap with many of those listed and those that are not...but I'm guessing you get the point... I'm finding that medicine is very much a team sport. Not a team responsibility...at least from the medic perspective, but on each patient I pull from many sources. I've become convinced that a network of intelligent providers is necessary if most of us are going to excel in medicine. There are constantly a ton of new ideas, as well as a ton of ways to accomplish them...I find I like it that way... Sorry Vent, I was just sort of trying to play on a paradox of your question. Equipment I can't do without and don't think I can educate myself passed. :wink: Have a great day all. Dwayne

I got this idea from here...A different thread But it got me to thinking. Barb (my wife) couldn't care less about anything EMS. She's not curious about gross calls..has no interest in why you can die without enough glucose, doesn't find projectile vomiting stories amusing. (For example we used to have conversations such as... Me "So can you see, because these molecules/atoms do "this", through a whole cascade of interactions you end up...say...Blinking!?! Barb,"So, what happens if they stop doing that?" Me, "Well, they don't really stop doing that...." Barb, "So I'm in no danger of suddenly not being able to blink?" Me, "Ummm...No...not that I can see." Barb, "Well, OK, then. What time do you leave for school?" Me, "But...there's all these molecules....And they're really tiny!....Oh...never mind.") I got to wondering how many think this is a good thing? I mean, she designs web pages on a small scale when not caring for my son and I, or our house and all that that entails, and I couldn't care less about HTTP// something/PHP/something.../something else.whatever....I don't get it...I don't want to get it...I don't plan on ever getting it. As long as she can keep my computer running...life is good. Understand, I'm not looking for marriage advice. We've been crazy in love for 22 years and have always been very different people. I'm personally pretty happy that she wants to talk about something besides medicine when I get home. It seems there are a million threads here at the City that say something like "It helps if your mate is in EMS so that they can understand what you have to go through." I was just curious about the experiences of those that have spouses that don't understand, and have no desire to understand. Does that bother you? Would you change it? Why? Dwayne

I was explaining that to someone the other day...didn't that come from an old song?

I believe this is absolutely KEY! Use your lectures to answer questions, refine your thoughts, not to introduce the material to you. Good for you... Dwayne

Pretty easy... Use the terms "basic" and "intermediate", they are both perfect descriptions...when you get tired of hearing them...move on. :wink: Isn't it illegal, like someone else mentioned, to misrepresent your level of care? (Bushy! You hush...we haven't been here in a while. I hate this question, but hate those that believe it's ok to use the term "Medic" when it hasn't been earned worse.)

I disagree. A pattern of such behavior speaks to a child’s future statistically. I've not seen evidence that a single event, regardless of that event, does so. To use your above logic. There are truck loads of psychological data to suggest you're looking for a zebra here. I'm unaware in neither my limited general psychology education nor my slightly more extensive behavioral psychology experience of any body of evidence that shows that even the most damaged child's first noticeable pathologic act to be the murder of another. There was a ton of evidence; the parents simply had other things to do besides raise their children. If by free pass you mean ignore this behavior. I don't. But he is what he was raised to be (with the exception of an incredibly small percentage of children). I simply believe it's an ignorant opinion that taking away this child’s life is the most productive thing to do. What rational criteria did you use to decide 20 years was a good time frame? What rational criteria did you use to decide perhaps 20 was too much, but at least until 18 years old? See what I mean? They are arbitrary numbers that have nothing to do with the mental health of this child. That logic is no more sound than the logic used when he "decided" to kill a baby so he could hear the TV. (Of course, he had no mental maturity to use any tools really) But, at least he had hopes of hearing the TV. He had the logical expectation of success...there is nothing in your plan that has the ear marks of creating anything positive except to those that want to punish because it makes them feel better. If he's, wherever he is, pulling his hair out in grief over the realization of what he's done...what is gained by locking him away for most of his life? If he doesn't understand now, but with maturity comes to understand, what is gained by keeping him in prison beyond that point? I am not anti punishment. I'm anti punishment that is based on pseudo psychology and knee jerk reactions that allow people to discard children so that they can continue to hide from their parental/societal responsibilities. And if that 12 year old, straight A student, that has been hunting and handling guns responsibly since he was 8 suddenly beats his sister to death with a bat? Then we need to seriously consider chemical/biological causes for this, along with taking a hard look at his parents. But we can't in your world, because he's suddenly become an animal not worthy of consideration. He now belongs in a cage, not a subject of study. As above. I hope it's obvious Scar that my responses didn't hold strictly to your reply. That was an attempt to expound on my points, not to misrepresent what you said/meant. No offense intended. As always, I look forward to your thoughts. Dwayne

You know, I didn't completely understand this argument before I started my latest clinicals. I’m precepting in the Springs now ( Colorado Springs) and have an amazing preceptor. The Springs has automated everything on their trucks, pretty much. But I don’t get to use any of it until I’ve decided what it’s going to tell me before hand. I’ve taken my sig line to heart in my clinicals (Maybe seems silly to you Vent, but made a huge impression on me!). My greatest terror is to walk into a house and be presented with a scary patient, only find I have no mental tools to treat with. So my medic, and basic as well, are a perfect fit. When I pull out the pulse ox I need to have decided what I believe it’s going to say before applying it. “What do you expect to see?”, “What lung sounds do you expect to hear?”, “Based on your assessment what do you expect to see on the monitor?” To the point now that I really don’t have any huge desire to use any tools beyond my stethoscope, BP cuff (I quickly lost faith in the auto BP while “playing” this game), my senses, and the tiny little brain in my head. In the beginning I almost always wanted to see what a machine said, and then decide if that jibed with what I believed. I can see now where that was a terrible weakness, that it would have spread to everything I do, and make it weaker. I’m grateful my preceptor expected more from me than I knew to expect from myself. When I was treating the chest pain with rales to near the nipple line bilat, have completed my chest pain pain/pulmonary edema interventions, and then was reassessing…was I happy to see 90% on the pulse ox? Hell yes! But his hands were pink and warm..no longer clamped on the armrests of his chair, breathing was starting to ease, pulse rate was down 25 BPM, the “oh hell, I am so dead!” was leaving his eyes…So I knew it was going to say something like that. Have a great day all. Dwayne

Let's see. This CHILD did a mindless, senseless thing by taking a life. So your adult, mature decision is to take away his life? Where is the difference? I would prefer we beat him to death with a bat. At least that brutality would have an end. He brutalized a baby for a moment and you want him to go to prison forever. You want to brutalize a 12 year old for the next 20 years. What punishment is right for you? This CHILD has had no say in anything to do with creating the kid that did this. He's a kid. Still forming. No clear PERSONAL opinion on religion, life or death, or developing tools to deal with rage. He is exactly the broken instrument he was raised to be. He needs to be repaired, not discarded. His parents created a ticking time bomb with no operational safeties. They should go to prison for that. This boy should go to a place that will allow him to become a normal human being. I'll ask you to believe that my anger is not directed at you specifically, but the attitude of punishing children behaving in the manner that they were raised. This boy is the victim of his parents, and that is were the rage of those that loved the baby belongs. Dwayne

I agree completely with Jake. Sometimes the anatomy and physiology can be overwhelming. But you know what, you've only just begun, all of the terminology that seems so foreign now is soon going to become part of your normal vocabulary. Do everything you can keep up and stay current on the material, but don't expect it to be easy, because there is a lot of material and it comes very fast, too fast in my opinion. If you can, try and get together with friends from the class and study together. I think that makes a world of difference. Good luck to you! Your posts show that you have the brains and the moxy to make this happen... and try not to take the nervousness seriously for at least the first couple of weeks. Dwayne

I thought your post addressed her's perfectly! I didn't think you were calling her out. I think you'll find that much of the learning here happens during the debates. Your post was smart and succinct. Hell, after you've been here a bit you won't feel your post was productive unless someone disagrees with you! Dwayne

See, I knew that being from Colorado you were bound to be a peach! Great post! I could be wrong, but I don't believe that's completely true. For example, and this is hearsay, I believe with AMR Pueblo (Perhaps others as well) to perfom RSI you must have one year as a 911 medic, take a class, and then be tested directly by the medical director. You are still the same class of medic (I believe) but have been given an additional skill individually. (Again, someone told me this, I haven't researched or made any attempt to verify it, but I believe it came from a credible source). Also, no worries on the edit as long as you note any content or context changes that are likely to make those that post after you look like boneheads... Again, welcome.

I think there are probably many things here that you might not have understood. For example, the patient was being transferred to another hospital. I'm guessing, though am not certain, that that would have required a Dr's intervention. How did he decide to transfer a patient that he wasn't aware existed until the unit was there to transfer it...? See what I mean? Sometimes we need to stand back and say "There was so much wrong with that situation, that perhaps correct things were happening but I'm just not in a position to understand them." Of course, other times folks can just be boneheads. Dwayne

I guess, as mentioned before, it would depend on what you wanted to use the numbers for.. I believe I've heard, though certainly unverified, that the majority of registered EMT-Bs are inactive. Went to class, got their cert, yet never moved into the field either paid or volunteer. (Was it JEMS that did one of their "myth" articles maybe? Not sure) I'm guessing that getting an active number would be tough... Just a thought... Dwayne

My apologies to all for slinging mud...Back to being a grownup now.. :oops:

CONTENT REMOVED - ADMIN Good luck to you. Dwayne

Here is a perfect example....defending you. Once again I was wrong. CONTENT REMOVED - ADMIN Dwayne

All you really need to do to put me, or any of the others in our places? Answer some of the questions asked instead of ranting like a child. You don't see me at all if you believe I'm looking for sympathy, because I came into this discussion prepared to be WRONG! I'm ok with it, I expect it to happen on a regular basis. I've been one of the only people standing up for you and your whiney, ignorant posts...Just answer the questions fire...and let's move on. Did you read the scenario? And if so, how many cyanotic patients have you had with sats in the 90's? Pretty simple really... Dwayne