Ridryder 911

There are several B.S. programs that have been discussed (use search), most use the last 2 years for administration or education, etc... I would think that all meet the standard curriculum and would allow sitting for the NREMT/P examination. Albeit, a B.S. degree would be preferable, I do not see much employment opportunities for them over a AAS in the field setting. Good luck, R/r 911

You will probably need to IM them, as well not post in the "Funny Stuff". There is an appropriate area, if you want to contact them and be taken seriously. R/r 911

I have purposefully not read or posted in this area, due to the same lame excuses and non humble replies. I do understand the need of volunteers in small remote areas that will never be able to support a professional EMS on its own, however; majority of volunteer EMS is because the " need of self proclamation"and in lieu of paid EMS. I usually can identify one by the arm extension and double joint, from patting themselves on the back. I have a simple way to find out true volunteerism. Require them to obtain the minimal level of an associate degree in EMS to perform, remove all identification labels, emergency lights, stethoscope around the mirror, multiple patches, etc. from their personal vehicles and persons. Require monthly in-services at the appropriate level, with failure requiring them to leave the service. As well as require clinical exposures for patient contact. After that, they would be able to maintain their certification level and volunteer as much as they want to. Sorry. but this debate is futile. The way to remove volunteerism is education. Requiring an academic level and continuous education at this level in lieu of "training courses" will separate those that desire to provide care and those that want to provide a community service because it is fun, and meeting their personal needs. R/r 911

Doesn't take a rocket scientist to use. Find the appropriate landmark and drill < 2 seconds. I feel they are a great tool, but should be used as last resort. As far as central lines, I personally don't think most can place them as fast and easy as an EZ I/O. R/r 911

Ironically, when I was designing trauma standard guidelines, I asked ACS where they obtained their specific standards and recommendations, they were unable to send me references or studies, rather they described it came from "committees". Again, another form of standards we based upon what? Evidenced base medicine ? nope. Ironically, ACS does not consider "burns" as trauma. That is why I believe we will see these recommendations change quite drastically and remember they are for channeling patients into their facilities to be examined by their "ACS physicians) =$$$. Hopefully, this and the "Golden Hour" myth will soon be displaced by hard fact evidenced medicine. R/r 911

I use it to refractory combi nebs, and found it will usually break the cycle. Have been doing for years.. without any major s/e.. R/r 911

Don't see any need of discussion, just typical diversion therapy. Attempting to displace effect and provide comfort. Don't see any side effects of giving something to a child to cuddle and place trust into. Hospitals, EMS, Police have been doing it for decades now. R/r 911

I do hope that she was encouraged to seek medical advice and not just "brushed off". Even as a former RN, she needs to be told the potential risks. Anyone having a period of diaphoresis, cold sweats, needs to be evaluated even though it might be transient in nature, it could be a precursor to something. Field evaluation is very limited, and everything we have for diagnostics is not in-depth enough to "rule anything out". R/r 911

The paramedic programs used to require a 16 week EVOC course when I attended, but they have did away with it. The reason is most employers provide it now, and one will use the emergency vehicle they are used to. R/r 911

It varies on how much it is, & will it be useful etc. My company just paid for three of us to become Advanced Stroke Life Support Instructors, this week which was a hefty costs and sponsored a few to CCEMT/P course. My job was to "beef" up the in-house education, so we did not have "send out" employees. For example we have all of the alphabet courses (PALS, PHTLS, NRP, PEPP, etc..) in house now, as well as at least 4 hour a month minimum CEU and starting a on-line CME on top of that. So it is all dependent on the education budget. Usually many will attend and pay, then he will reimburse afterwards. R/r 911

Uh.. cut them down... Serious, if it is not too late.. which usually it is. I was taught to cut the rope at a distance at least 12-15" from the knot. Never cut through the knot, for forensic reasons. Of course you are going to immobilize them and take spinal precautions, even when intubating. Chances are the have a Hangman's fracture which consists of the bilateral pedicle or a pars fractures involving the C2 vertebral body Like many said.. too many variables. But the basics is let the Rescue take over and secure and stabiize the vehicle before entering. Dependent on the injuries if I would take out time to place all the immobilization devices on the patient or move as a unit. What injuries? Other than immobilizing, what else can be done unless you are discussing lacerations, SCW, etc.. other than that there is no "real treatment" for back injuries than immobilization. R/r 911

Actually, the Medtronic and Physio Control actions occurred several months ago. No big deal, it was a corporate position. They (Medtronic) released Physio Control as it was in the beginning as a separate company. The recalls are limited and isolated like any other medical equipment. If you have a problem contact your representative (which might have changed, with the corporate shake up). One can read about in JEMS, as well as EMS Insider. Now, back to your local social and philosophical debate, in progress. R/r 911

Amen ER Doc ! Well stated! It appears that every "over concerned mother type" that describes that she "cannot afford" the Tylenol or Motrin for their kids always have a couple of packs of cigarettes in their purse or a pack in their pocket. I ask, how much does a pack cost now a day? .. Of course .. that appears to be a different thing. R/r 911

Don't think it is a government or legal thing? Obtain a divorce and see how much government has to do with it. Pay taxes, then you should be taxed as single (no married deductions) etc..right? You can't have your cake an eat it too! Government should keep their noses out..? What about those idiots that believe in marrying minors (<10) should be legal (and yes many are well educated) and those that now believing in beastiality should be okay as well? Hey, it should be their right? .. Hey they are not hurting anyone right ? Where does it all stop? .. You may think I am over the top, but anyone discussing same sex marriage even 15 years ago, would have laughed at you as well. Sorry, there is right and wrong. Too bad you get upset with some moral values and integrity. Yes, it is a shame that the Government would have to be involved. Unfortunately, the world has lost most of its common sense and now someone as to say.. sorry that is wrong! It goes against the laws of nature. Just because it is cool and the fad at the time, does not make it right. What concerns me the most is the attitude and lack of moral values that many younger adults have. It is okay (as long as one does not get hurt) and anti-establishment and poor work ethic type attitudes. It does remind me of the 60's and we know where that went. James, I love ya (in a non-sexual way ) but let us remember many have died as well in the name of owning land, property and in the name of science too. Not all things that was being in the name of science is right or accurate either. Yes many have died in so called religious wars and still continue to do do. Unfortunately, most were enforcing their ways and ideologies not the teachings of the religion or faith they were supposed to be representing. Similar to what is done now per terrorism and the Karon. I can point as many wrongs science has produced by poor and inaccurate treatments, and false findings as those in the religious nature. Just science attempts to hide it and it is brushed under the table as "inconclusive" What confuses many is religion and science can actually go hand in hand and not battle each other or one has to take one side or another. I am just as tired of being forced to watch or even have different views crammed down my throat as well. For example Tuesday night between 6 and 9 pm, three major networks (including cable) had television dramas regarding "gay" topics. Sure, I changed the channel to only see it again and again. Now even here on a medical forum, guess what we have? ... No agenda ?..hmm Sorry, you are not going to change my mind, like I am not going to change your mind set. However, do not accuse those that disagree with it as being a bigot, narrow minded, and unintelligent, when I could say the same defense. Those that recite how inaccurate and how mythical the Bible is, does not present to understand the history, the defines and scrutiny was followed, and the level of education of those that taught scriptures over centuries, not decades and a few years (<1000). The difference is now many (like myself) is no longer going to accept criticism without a fight. So many for years have turned the other cheek (pun intended) and was forced to change views, or be called a bigot, or emphasis to be ashamed and now are legally fighting back as well through legislation and laws. Just as those that claim discrimination, I can describe the same as well that I have to accept something that I do not believe in morally and my faith teaches that is wrong. Like I described earlier, I have friends that are gay. They know my opinion, and like other those that practice immoral acts does not mean I ridicule, harass or treat them any indifferent than any other person. For you see, that is what my faith teaches me (Christianity). But, that does not mean I have to agree or accept that it is right. By my faith I am to point out the action is wrong (not judge you personally) and then you are to make that decision, so yes fee choice again. VsEh, I respect you as a person and especially your knowledge in EMS. I do wish I knew the reasons for such antagonist views against Christians. I am sorry if you do not understand the concept of Grace, and that the body actually has a soul. If ever some self proclaimed Christian(s) ever hurt you.. unfortunately, we are human and like any other groups we definitely have poor representatives. If that was the case, we apologize. I still pray for ya! R/r 911

My suggestion is not to EVER tell anyone you were in EMS. It is far better to thought as equal playing field and many instructors either hold EMT's as higher or much lower with prejudice. Nursing and EMS are 2 different professions, and are nothing alike in instruction. Remember, you are in their world.... don't attempt to rationalize or compare your EMT training to nursing. Nursing is not medical model based teaching it is nursing and use the nursing process (which you will know by heart). If possible take to brush up on research and writing skills, especially APA format, you will use it. Learn on how to manage your time well. I laugh at medic students whom complain, in nursing you will study at least 8 hours a day every day. Remember, you will complete those 2,000 page textbooks in those 8 weeks plus all those other projects and research papers, care plans, and clinicals. So the old adage "Is their life after nursing school ?" is correct. That is why RN's respect each other, we all had to go through it and still remember it. Kinda a right of passage. So time management is essential. Good luck, and remember persistence is the key! R/r 911

Why have recruiters when you have a stack of applications on the desk ? In another 90 days you will have another again. I agree it sucks.. yet again the so called profession is not yet made it to a professional level. I have been a recruiter for my service at one time and attempted to promote such from services, but it did not catch on, again because it employers did not have too. You see recruiters in nursing depending on how short the supply and demand is. Lately, the past few years instructors informed me they have not been active. When I first went to nursing school, I only bought my lunch once... it was always brought in or purchased to the class by recruiters, definitely, not that way in EMS.

You may not want to be bothered with free will, but that is what always gets you roughed up. First, whomever said God make mistakes is wrong. It is not God's will for anyone to sin or go against his will and teachings. It is a recognized choice that one makes, as well as asking for forgiveness of going against those teachings. I feel as many do many homosexuality affairs is usually a choice not always genetic or "born that way", I do believe some are from possible scientific and medical reasons and that is a different point. Remember, it was not that long ago it was considered a mental illness. I and like so many others, feel the increasing practice is because the new label of being "cool" and is a new fad. Just because it is "generally" and socially accepted does not always make something right. There is right and wrong, no matter of what the situation maybe. Even scientifically, for one that agnostic or atheistic and believes in evolution, it would be against the laws of nature. VS EH, again you are stating wording of those times as actual of today, instead of the intent on reciting the Ten Commandments and you know it. As many attempted to justify slavery in the past times of misquoting and misinterpretation of Biblical scriptures. The times, intent and wording has to be closely regarded when interpreting scriptures. That is why Christians are encouraged to study and research and understand what was going on at the time. p.s I still pray for ya!.... R/r 911

Okay a reality check. As a RN, I am quite aware of when I am "covered and not covered" by the scope of practice and as well as liability of hospital insurance. RN magazine a few years ago had an article in regards of "going outside the hospital grounds" on how the nurse is exposing themselves to liability and possible litigation. As well in my state, unless that nurse is a licensed Paramedic or personally licensed in that EMS as a "speciality care" under that service protocol, they are not allowed to perform actions and would be considered practicing medicine without a license. Yes, if the EMS (ground or air) is associated or owned by a hospital then that nurse maybe covered by their rules and insurance however; if they are not the nurse is acting upon his or her own ability, since the patient technically is no longer a patient of that transferring facility. Again, if the EMS is not associated with his/her agency she is acting upon her own regards and can be considered practicing on her own regards, even if ordered to. Yes, it is the responsibility of the institution to make sure that the care is equal or above for transport of any patient. That is wonderful rule and if the world was perfect, it would be followed everytime; but in reality it does not happen. This rule even applies for patients going from ER to a CT scan..yet hospitals still allows transport techs to perform tasks and as well allow BLS EMS services to transport critical patients. Ever seen an EMS transport a patient from a hospital in active labor.. same rule applies. Sorry, I have been an ER manager and a RN/Paramedic for several decades and continue to see violations of EMTALA and COBRA in regards to treatment, transfers and transports all the time. Now, you will not find very many reporting such for many reasons. One of the many reasons is that transferring hospital agencies is owned by the receiving agency. They definitely do not want to create a fine for themselves. As well many small communities do NOT have ALS and they do not want to be labeled as the "bad guy" .. so it continues and take the risks. Yes, it is "crazy" for it to continue, but it does, as well it seems to be increasing instead of decreasing as corporations own more and regional smaller hospitals, but not involved in those EMS systems. Remember, also if that facility is not able to provide care or procedures they can be responsible (legally and liability) for the costs of transport which they do not want to pay for. Yes, I agree it is a crazy and foolish gamble, but it appears to be one they are willing to take sometimes. R/r 911

I don't know what cave you live in, but I have seen cardiac and trauma patients transported by BLS crews with balloon pumps, vents, IV's etc.. Yes, it is scary as hell, but it is done. Fortunately, this was not in my state but I have seen it in several others and it was not that long ago. Hospitals do not care as long as the patient does not crash, also the moment the nurse leaves hospital ground his/her malpractice insurance from the hospital is voided and in many states their license is neal. Hence the reason for CCP was even developed. R/r 911

VS just when I thought you have calmed down.. Okay I will say it .. It's wrong!. Sorry, the human body and laws of nature was not developed for such. Yes, my personal beliefs is that is not morally right as well. I believe marriage to be of the opposite sex not of one gender and should be considered sacred Do I have a problem with gays or homosexuals on a individual basis no. Actually, I have several friends that are gay and have worked closely with several, however; this does not mean I will condone their lifestyle. At the same time does not mean I homophobic or will chastise them as well. There are plenty of persons I have made friends with whom lifestyle and behavior is definitely not one I would choose or promote. Yes, I donate to organizations to promote ban of gay marriages and supported state constitution to prevent such. No, I do not wish ill or harm to others and no it does not make one mean and awful because of one considers this immoral. Just a different view and thought. R/r 911

This is a common "myth". Critical care courses can be self designated, unless specified by the state or local ordinances. Even Maryland's CCEMTP is not really named as a Critical Care Paramedic course, it is a critical care emergency medical transport program .. thus CCEMTP recognition not really labeled critical care paramedic. Medicare has labeled EMS services that provide above the "normal" level as speciality care and those should have additional training and education... thus critical care paramedic. (Basically, anything above medications listed in the DOT Paramedic curriculum). This can ventilator therapy, IV medications, RSI, Neonatal, etc.. Now, there is some other Intensive Care, Critical Care programs for Paramedics being introduced and will be interesting to see what becomes of these. There is only truly one test that certifies a Paramedic of having critical care knowledge and that is the FP-C examination. Which one does NOT have to have Maryland's course to become one. However, one should have a increased knowledge in critical care (not emergency) subjects. http://www.certifiedflightparamedic.org/cf...%20handbook.pdf R/r 911

I believe you are making things too difficult. Just do your job, and don't worry about whom or the ranks. The old addage the "chief's will find you" is true. Usually, if it is a large situation, I look for the "white helmet" or one that is not doing anything, that is usually the one in charge. Good luck, R/r 911

Well, its official EMS has went to the dogs!.... R/r 911

There are as many reasons for extreme costs of health care (trauma included) as there are diagnosis. First trauma never pays off. figure that was a cheap ER bill. The average traumatic brain inury (TBI) costs into the several hundred of thousands dollars; up to millions. So yes, it is usually is astronomical... but remember those that usually get stabbed, shot, clubbed and then have to have major surgeries, trauma ICU, rehab, etc.. usually do not carry Blue Cross and Blue Shield insurance. As well, there are those (probably like that patient) that will never pay for their expenses. Now, multiply this by the several millions of patients that never will pay, one can see part of the problems. ER being used as "free clinics" has to be absorbed into the problems as well. Then as the story described.. " he was in a room with a junkie for five hours".. Do we think that junkie paid for his ER visit too ? Now, part of our problem is we (EMS) do over triage. Read posts, that regards any type of significant trauma scenario. Most EMT's immediate reply is "send to a Level I trauma per chopper"... which is not always the most appropriate treatment in fact in majority of the time. Remember Level II's, Level III's can handle many of the trauma cases there has not been any proof helicopter transports decreasing mortality and actually saving lives (yes, even an old Flight-nurse/medic hates to admit it, but it is true) . As well, we need to get out of the "golden hour" mind set thinking that every trauma patient requires such services, as was exampled in the story. That error cost the patient several thousands of dollars calling a "trauma alert". when in fact it was not warranted... in the long run, EMS looked foolish. More education in quick detailed assessment, the ability to utilize better judgement of those that do need Level I trauma services (surgical candidates) and those that can be treated successfully in other centers. More studies of accurate determination of trauma injuries that require surgical intervention, than standard protocols that have been handed down for decades to feed patients into trauma centers without scientific validation. R/r 911

Many of the "synthetic blood studies" have been pulled from FDA. There had been an increase in morbidity and controversy of consent in studies. Hopefully, they be able to re-establish more studies.. since I have stock in one of the companies.. :? R/r 91