Eydawn

I am much more in favor of underage folks being part of a 3 man team with two fully certified adults. And the clincher is they REALLY shouldn't be driving. Teenagers, especially males, have enough problems with managing adrenaline as is. And younger drivers go faster and wreck harder HOWEVER... I will say if they are providing care that is as competent as any other EMT-B (and for the love of God, before we start that again, we know our current Basics are undereducated), and are being closely monitored for adverse reactions or emotional problems, then this is *not* the worst situation in the world. Nor is it the best. But I have found a striking difference in maturity between individual teenagers... and those who live rurally tend to have their heads screwed on straighter. Definitely not ideal. Definitely illustrates that we need to make some changes. But don't make fun of the kids for getting involved and trying to learn something. Be adults- if you really want to do more than take potshots at kids who are being set up in this position by their system, go mentor and provide some good influence. Wendy CO EMT-B

For a home hospice type situation if you have leftover meds, take them to a pharmacy for disposal. They have the faciilties to deal with it. That or they can tell you where to go. Wendy CO EMT-B

MAOI's interact with asthma meds? I don't remember reading that... and I read about everything I take. What exactly happens? Wendy CO EMT-B

Damn! It was worth a shot. All I could think of improvising, really! Bummer. Wendy CO EMT-B

I'd actually prefer a passel of the older boys to come with the leaders... have you looked at your typical scoutmaster lately? They got the skillz... but some of them are approaching McFatarse status! You need the older fellows who are in better physical shape if you want to accomplish something. But for the love of god, unless you want them to take photos and make a photocollage of the scene, don't invite the Girl scouts.... So now what? Can the helo get this guy out of here? Is the duct tape and LSB trick even viable? Wendy CO EMT-B

Boy scouts... always a good idea. Girl scouts don't play with knots and ropes in my experience, FYI... the troops I've seen SUCK. Are the SAR guys who are 15 minutes out bringing more rope? Please say yes. I'd send down a 2 man team with the Stokes basket... If I trusted the tree enough to belay 2 responders plus a basket full of injured dude. Get them to rappel down on either side of this guy... have them control the basket as best as possible, and have the guys on the surface ready to take the extra weight. To be honest, I'd grab this guy wherever it was possible and try to keep the spine in-line, but not be too worried about it because this is a truly difficult rescue move. Put him in the basket, have the basket and the responders pulled back up. Or if you don't have a stokes basket... some really really good straps and a scoop or LSB. Duct tape, if you must... anything to keep this patient strapped to the board. But again, that's my semi-uneducated guess. Wendy CO EMT-B

I notice you didn't address my request to help us get the ball rolling... If you think we can dump EMT-B's entirely and start from scratch while still being able to provide anything near adequate medical care in America, then show me how it's going to happen. Also, please show me where the money is going to come from... since we all know EMS is just rolling in loot at the moment... and how creating another unemployment wave will allow anyone to just "go to school" to become a paramedic. You missed the whole gist of what I was saying, Dust. Didn't you notice that I wanted to change protocols so that they were tailored to the level of education we've got now? I'm not advocating giving basics more skills, I'm advocating winnowing things down so that it's something that actually works with the tools they've got. By creating more specific requirements for things like "treat and street" you're not degrading the level of medical care- you're removing some of that responsibility from providers who through no fault of their own in many cases have not been educated adequately. You're installing some fail-safes. I'd give you some more credit for this response if I had been advocating permanently keeping our current EMT-B's at the educational and training level they're at. I didn't. Why does there have to be an interim? Because bureaucracy moves like molasses in January, and if we simply fire all the basics or intermediates currently employed for performing at the level that's been required of them, we're going to look even worse. Things don't happen overnight. Now, if you really want to see this change, how about addressing the other part of my post? How do you propose we *really* start changing things? What's your plan of attack, oh wise elder? Give us some ideas and let's get it going. The longer we take screwing around complaining about basics, the longer it'll take to change things. Wendy CO EMT-B

One of my friends who studied abroad in Australia thought this was hilarious! Wendy CO EMT-B

Nurcenary! What a fantastic name! Gotta love that. Matthew, did you know where you might be looking to move stateside? I can give you some info on CO flight services (although I'm a ground-bound basic, I'm a good info fetcher!) Wendy CO EMT-B

Yes! Got the key, reconnected the wires, key doesn't work in the ignition! Can't get the trunk to open! Argh... Wendy CO EMT-B

So what do we do in the meantime, while we're still in the forum discussion stages of this educational change that a lot of us desire? Let EMT-B's use older protocols that don't integrate some of the knowledge that they could? I for one think CBEMT's idea of a checklist is a great idea... because, even I didn't realize that there were some oral agents that diabetics took that could cause a PROLONGED hypoglycemic episode. For all I've learned about the disease and despite having a parent with Type II, I had absolutely no idea that could happen. Never heard any EMS individual mention it to me, either in class or in the field. So what are you going to do? Let an EMT-B who's confronted with a superficially easy case operate on that reduced knowledge base and maybe harm the patient? You can talk about change all you want, but if we are going to do anything about this, we're going to have to develop an interim plan and a way to integrate the providers we've already trained, or we won't be taken seriously. Part of that interim plan has to be better protocols, tailored to the education level we have now, taking into account the lack of pharmacological etc. knowledge that many EMT-B's have. Part of intelligence and ingenuity involves accurately assessing the resources you've got, estimating the time it will take to change to the system you want, and learning to utilize what you've got now in a better manner until you can get the ball rolling. So how are we going to do this? How do we convince our educational system that this is what we really want? How do we change the payscale that we'll be receiving once we've all got these shiny degrees? I don't want to hear any more of "this is what needs done," because the majority of people who are going to agree with that position on this forum have already been convinced. I want to hear ideas about HOW. And I'm willing to help... I just need to know what the older and wiser heads think before I jump in prematurely and screw things up. Wendy CO EMT-B

I've got everything and reconnected the wires... gorramit! Now what? Wendy CO EMT-B

Sawheet! I love basset pups. Does yours trip on his/her own ears? Wendy CO EMT-B

You have a basset pup?! You lucky son of a gun. Pictures!!!! Wendy CO EMT-B

Glad to hear it! Good luck and let us know how it all turns out. Wendy CO EMT-B

Find a school or instructor where you like what you're seeing. Then ask if you can help with the skills labs. That's what I'm currently doing... the instructor for my fiancee's class rocks, and I was lucky enough to get to help with the skills lab on Monday night. There's nothing more fun than teaching in my opinion... That gets your foot in the door, allows you to see if you really like teaching EMS, and then gives you a contact to work with should you decide to go further as an educator. Just my opinion on the matter! Wendy CO EMT-B

Well, not to sidetrack here... but my friend's EMT-B class in Michigan included water rescues.... Just an FYI! If you don't have it, don't jump in the pond. If you do, it's at your discretion since you're not on the dive team. Wendy CO EMT-B

Lady's able to eat? Get her a sammich! Mm... sammich! Should keep her from tanking again right away, no? Or was this a "you are in the ambulance and gave her D-50" call? Let her blood sugar normalize, give her a sammich and let her sign a refusal if she wants. If she doesn't want, take her to the ED. Did I miss something? Wendy CO EMT-B

But that wasn't the patient's problem. :roll: There is a distinct difference between altering the chief complaint via language use and describing it in a different fashion... Let's put it this way. You describe what you see, but you don't put it in your report as "Patient looks like a crackhead to me and doesn't understand that cold weather makes things shrink... quote from patient 'etc.' " Your language should always be professional, and if your patient's language is vulgar or vague, it is up to you to fill in that blank with what you see... For example if you had a psych case screaming "F*** YOU F*** THE WORLD F*** THE PRESIDENT THE F***** ALIENS ARE HERE TO KILL ME AGAIN OH F***" you don't put that as the chief complaint... you describe the situation. "Patient is a 20 y/o male with altered mental status as evidenced by shouting, use of profanity and description of attacking aliens." Well, Dust... *shrugs* you document it how you want to, I'll document it how I always do, and we'll both try to dodge the lawyers, lol! Wendy CO EMT-B

Are you looking for an undergraduate institution that has a good pre-health professions program? Or are you looking for somewhere to go through paramedic or nursing school right off the bat? I would advise you to go for somewhere that has a well acclaimed pre-health professions program. For example... I started off as a Health Sciences major at Kalamazoo College, in Michigan. Great financial aid from those folks, although I'll be paying off loans for quite a while. Then I realized that the Health Sciences major was too limiting; I switched to being a Biology major while still going to most of the classes considered to be in the pre-health profession track (with the exclusion of Organic Chem 2 and Biomedical Ethics... chem because I hated it and didn't want to go to medical school and biomed ethics because of a time conflict). Then I got sick of having asthma problems all the time in Michigan and transferred to CSU in Fort Collins, Colorado. I am currently a Biological Sciences major, going to graduate come fall. I'm taking the rest of the classes necessary for the accelerated nursing program offered at CU for those who already have a bachelor's degree. The college education is a valuable thing. But make it a true education- not just a set of classes that you need to get into a specific program or complete a specific degree. I've ended up taking religion, ethics, history, music, English composition and literature and various other classes, all with various emphases on world culture. I enjoyed every second of it, too (although those who know me during paper-writing time would argue). You can always go through paramedic school. Once life's responsibilities grab you, it will be much harder to get a bachelor's degree. Think about what else interests you in life, look for a school with a good science program, and combine the two. There's college books in your academic counseling center at your high school (at least there should be); spend a couple lunches perusing them and jotting down ideas of schools to look at further. Then get online and look at those schools and eliminate things that don't seem appealing. By the way.. if your parents are broke, you will be eligible for financial aid. Trust me. Wendy CO EMT-B

Seen the bus that got converted into an ambulance? It was posted up here a while back... had bariatric capabilities, seats for those not requiring supine position or spinal immobilization, room for about 2 cots and then basically bunk-stretchers for those who just need to lie down... It was really awesome looking. Heck, where you are, they're all trying to get on the bus anyways.... Wendy CO EMT-B

Easy enough. Describe what I'm seeing, then include what the patient is complaining about. "Patient is displaying altered mental status as evidenced by behavior, dress and chief complaint. Patient is bare to the waist, moving in an agitated fashion, speaking rapidly and ingesting hot water and cold milk alternately. When asked about why EMS had been called, patient stated "Let's go! I'm ready to go! I gots to go!... Can't you see the problem?... It's my dick!" At this point, patient disrobed and stated "My dick be all drawin' up and s***! And it's turnin' white too! Let's go! I gots to go!" That answer your question? I'm a fan of comprehensive documentation. Brevity is appropriate when the situation is easily visualized and uncomplicated. Descriptive reporting is appropriate when the situation is complicated or difficult for someone not at the call to visualize. I want my medical director to see what *I* saw and know exactly why I rendered certain treatments. Oftentimes, this will justify what actions you had to take during the call. C'mon, Dust, I thought you were all about being professional and making sure that your documentation is complete (including proper sentence structure, spelling and punctuation!) Wendy CO EMT-B

Can I just say that I hate the term "global warming"? It should be something more like "globally mediated climactic fluctuation towards extremes as a result of overall atmospheric temperature increase." Not as catchy though... seriously, global warming doesn't mean it gets hotter and hotter around here, what it means is that global weather patterns are polarized due to intensified disturbance in the system from air circulation patterns being accelerated and changed.... meaning you get hotter, drier summers, the ice caps/glaciers start to melt a bit during those summers, and your winters and precipitation patterns become extreme and/or unpredictable. Make more sense to anyone? Wendy CO EMT-B

Quoting directly that "John Doe stabbed me with a knife" and putting down the patient's description of something in a vulgar fashion are two different things. If you're going to put the description from the patient, preface it with the actual complaint first. That way there's the objective description of the incident and the patient's statement about the incident. Case in point: "Per facility nurse, EMS called for visible injury to pt.'s genitals secondary to prolonged masturbatory episode, described by nurse as 'he jerked off for 36 hours and now his joint is bleeding.' " "Patient is complaining of lower gastric distress with gaseous emission, described by patient as ' I've got the farts so bad I thought I was going to blow the toilet apart ' " That way you retain YOUR professionalism, while retaining the actual patient's description of their chief complaint. Wendy CO EMT-B

There's better ways to document on that PCR. I don't think this is intentionally "racially inflammatory" or "insensitive"; I think it's just plain stupid, and probably due to misguided PCR education. We're supposed to HELP our employer play "dodge the lawyer," not give said lawyer more ammunition, no matter how ridiculous it may seem. Here's how I would have documented it: Chief complaint: Head laceration approximately 4cm in length with depth of 1/2cm secondary to blow from bottle per patient's description of "[someone] done hit me in the head with a 40oz." See what I did? Professionally described the injury, as well as including the patient's description of MOI, without including vernacular and clearly indicating that I've slightly altered the patient's statement. If I were to be questioned about this alteration, I would indicate that the patient's statement contained language that might be found offensive and elected to exclude it from my report. Here's another example of something I might censor: 21 y/o male patient w/ possible ETOH involvement, victim of "2 dudes syndrome." If I were to document his words exactly when I questioned him about the incident, I might get in trouble. "Well, I was minding my own business havin' a coupla drinks when these 2 motherf$%*N sonsabi^%$ jumped my $h!^ and beat the F$*%&N $h!^ out of me. What the F(#& man, my junk is trashed and I can't breathe so good!" Let's see how we could translate that... "Patient is complaining of shortness of breath and pain to the groinal region secondary to a described assault by two perpetrators. Patient states that he was ambushed and physically assaulted. Patient is verbally agitated with possible ETOH on board; physical findings are as follows...." Now tell me that you wouldn't do the same? No reason to write out profanity verbatim; we're not the PD and this isn't a criminal case for us. It's just a patient we need to treat and document accordingly. Wendy CO EMT-B