Ridryder 911

Other than maybe a little ST segment slur, I concur with others one can not make diagnostics of a single lead. Symptoms are to vague. R/r 911

It is not I dont think causal attire is not appropriate, especially now it > 100 degrees; however if I was interviewing first impressions are lasting. Just like others have described, well groomed, professional neat appearance. Please don't wear white socks with black pants and shoes either :wink: Act interested, ask me questions about protocols (maybe if possible to review) the future of the service within the next 5 years, and the usual questions. So many never ask questions and ask desperate to get a job, which also concerns me. There is a unwritten happy medium of asking appropriate questions and listening. As I said before a professional thank you note sent the day after .... will be noticed. ( Be sure to get a business card) good luck, R/r 911

This is a very hot topic in our area at this time. A friend of mine granddaughter was recently murdered. She was 2 years old and while my friends son was in Iraq, the mother and a new "boy-friend" obviously started abusing this child. My friend and his wife kept a journal with pictures, documentation and frequent visits to physician, and yes even to child welfare division. All of them stated ... don't worry it is normal for the child to have received 1) femur fracture 2) humerus fracture 3) CHI all of these within the past year. State officials finally went to court with my friends persistence. The Judge refused to remove the child from the mother.. and now because of this, the mother and the boyfriend is being prosecuted for murder and the innocent child is dead. Ironically I read the family is now suing the physician that examined her.... good! Yes, we go through in-service annually to brush up recognizations of symptoms of child and geriatric abuse. Although, usually we do not report directly to child welfare, we do inform the nurse, the physician, and document suspicious findings, without directive stating such. I always tell the physician if he does not inform child welfare, I will. Not only bound by conscience but legal as well. There have been a few times that I have, when the physician did not. R/r 911

Perform a detailed neuro exam.. obviously nothing will be acutely performed in the field. In the ER, I would get a CT without and await radiologist findings. Get the number for neuro on call. I agree, sounds like she had a slow bleed and now may have some ICP. R/r911

I agree, it is nice to see one to be "humble". We all get wrapped up so much and loose sight the real reason and purpose of why we went into the business to begin with. To remember that each person is an individual, not just a run or neat case. Last night my class toured a children's medical center were we will be practicing at. These children range from 2 weeks old to 18 years old. The average length of stay is from 2 weeks to 2 years, with severe disabilities from either medical conditions or traumatic injuries.. It was a real eye opener to see small children that have never lived outside hospital walls or never have been detached from a ventilator. As well, they have never experience a holiday in a home or know what it is like to see their parents on a daily basis. This definitely makes it harder to gripe or bitch about the weather, the kids yelling or even the next call. Knowing there is those that would trade your predicament in a split second. Dr. Bledsoe is a unique physician I was fortunate to receive a personal e-mail from him a couple of weeks ago. Corresponding with him I can attest that his heart is truly into progressing EMS and wants this profession to grow and be respected as it should be. If we were to have a few more active physicians like him, it would be amazing what would occur in EMS. R/r 911

Man, this makes me scared. As a person that knows professional dress, I agree you can never over- dress. I personally would look at the person that would take the time to wear a suit and tie,or even a dress (females). Sure dockers and polo is usually accepted as sports casual, but have we in EMS became to "lax"? This is a job interview, if it is not any more important to you than to put your best foot forward, something is wrong. As wrong as an employer not recognizing those that can obvious understand that as well. When I did interviews, the array of dress was always amazing to me. From jeans, to cut-offs etc. I sometimes would have those with great reputations of being a great medic, only to show up slouchy or poorly dressed. They usually never made it back to see me. One can be a great medic and be a lousy employee, remember you are no just representing yourself but the company as well. Not respecting me, the position, or the company by arriving dressed to causal or slouchy means to me you don't respect, care or take those positions seriously. If you arrive too slouchy or too informal for an interview, what would you be like at work? If I was the manager, we would never know. R/r 911

Ask and you shall receive: http://gaems.net/download/drugcalc.pdf Good luck, R/r 911

We used to have a mandated helmet law. INMHO allow them not to wear the helmet, but sign a disclaimer in case of accident insurance would not cover them. On an anecdotal not, there are very few incidences that I have seen that speeds > 60 mph, that it made a difference. R/r 911

I agree he was an anus before hand... I would pick on basics, but I don't have to.. all I have to do is just stand back and watch! R/r 911

Ever heard of the milk and cow theory? Why pay for the cow when the milk is free? As well there has been numerous posts in regard to this subject... R/r 911

So far we have 12 thumbs down... on our crew. Maybe we can be lucky and be one of the fastest shows canceled. As for as bitching, I think we ought to bitch loud and strong!.. that is the way, other poor portrayal. of other professions change things. Apparently, someone read the posts on here.. maybe, they can read these. Not just looking for accuracy, but at least be somewhat realistic in life, and have a clue what you are supposed to be portraying. Yes, if there was consultants, and were allowed to change things and didn't... shame on them ! R/r 911

Here is an excellant site for more detailed EMS hx. with some pics... http://medinfo.ufl.edu/other/histmed/lemire/index.html R/r 911

I wore no special patches as well. Our logo and name was embroidered on our flight suits.. There are a few flight medics in this forums, just ask away.. First- do however a search 1'st. Now let me answer a few frequent ones.. 1. Yes, get all the education you can. Preferred degree, with all the alphabet certs.. (ACLS, PHTLS, NRP, PALS, AMLS,) Paramedic CCEMT/P or FLP the minimum. 2. Yes, most recommend at least 5 years experience minimum as a Paramedic, with extensive experience in urban, aggressive rural or metro. 3. No, the pay is not that much difference and actually may be lower than ground transport EMS, usually it is based upon experience 4. The usual configuration is a Paramedic and a RN or Paramedic and RN/Paramedic 5. Yes, it is exciting however; it is like every other job and has it bad problems as well. 6. Do not recommend those that have even a slight claustrophobia confined spaces or gets sea sick/motion sickness easily. 7. Yes, there are sometimes height and weight restrictions 8. Yes it is physically demanding and the glamour wears off very fast. You are not just busy with patient care but safety on the ground, air The statement "sterile cockpit" does not refer to medical care 9. It is a VERY competitive business, they have a love/hate relationship with each other. It is as well a very government regulated business. 10. Yes, it is a VERY dangerous business... Yes, you may DIE! This happens way too often, and no I am not talking a couple times a year.. check out WWW.Flightweb.com and yes many do enjoy and love their flight jobs and there is nothing else to compare with it! R/r 911

I agree it depends on the situation as well as the injury and illness. Would a clinic be called definitive care or is it the person (physician) the definitive care? I interpret it as well as to have the ability to "rule out" or eliminate process, and either transfer to a more definitive care or have the ability to solve to treat the problem. R/r 911

Actually, I would not give it.. I would clarify it although. Although, it is a personal issue, I rather err not giving something rather than giving something that is out of reason. As well, I would make sure I painted the clear picture for them as well. Maybe there is a lack of communications.. AHA more rather ECC is the accepted national studied guidelines, however don't be confused that they the national standard of care .. in which they are not. I heard the old saying ' they better follow ACLS protocols" which really means nothing. As long as the physician can verify their experience, knowledge they relatively safe. Where do you think the new ones came from ? R/r 911

IMHO, protocols are recommended guidelines and should be written and directed as such. Having a breadth of knowledge of where to place those guidelines when and if applicable to your patient becomes the key point. Being able to make a sound clinical judgement and treat accordingly. Yes, the medical director will definitely will be held responsible, even if the medics acted ignorant and upon their own.. again, the role of the medical director is more than a protocol machine, which many do not understand. This will not excuse the Paramedics as well. They will be held accountable for their actions. There are more and more cases where the medical director is being excused from litigation, and the Paramedics are the only plaintiffs, if it is shown that the Paramedic totally deviated away from guidelines/protocols or acted upon one self. Now, does this mean that Paramedics are allowed to practice medicine and administer medications to situations and problems without protocols and practice medicine on his/her license certification. This is not only foolish but illegal. Again, it resorts to education. Knowing and performing a detailed H & P , what medication(s) if any is needed and applying accordingly either by protocol or verbal orders. As far as the scenario of wrong order, you are supposed to be educated in the areas you work in. The Paramedic is held responsible for knowing the logistics of pharmacology, use of equipment, and proper application and administering of such. Just following orders is not enough. The Paramedic will be held responsible as much as the physician giving the wrong order. If you receive an obvious wrong order, repeat it, clarify and then describe that is a deviation of protocol.. if you know it is dangerous, err on the patients side. I rather have an ass chewing for not following order than to explain why I performed a dangerous task. That is why being fully educated is so essential.. one has to know the right and wrong and not rely upon another decision(s). Be safe, R/r 911

Good ideas, this does bring up some interesting points as well as for instructors. How much lab time, do you spend with your students, as well when running "arrest scenarios" do they verbalize or actually perform all skills, for example like placing defib pads?.. I know I require electrode placements, and I have a case of expired meds that they are required to administer... verbalization and performing the skill is essential. I agree most of what our performance is acquired outside the classroom... and again that is why clinical settings are so essential. Tidbits of working knowledge, is honing ones skills and when to apply and not use as well only comes with true time and experience. It will be interesting to see, what other information people have obtained ... R/r 911

Wow .. I am surprised of all the systems that use it.. I thought it was ancient history and no one used them anymore. Serious, we had one for demo only.. ( it came as a free grant w/monitor, so my boss took it for the monito) and it sat in the ER broom closet for about 10 years,turned on twice. I believe we sold the base station at a garage sale for about $10 and that was because it had a tape recorder and oscillope on it...still in the box... R/r 911

Learn in high school.. hell, I would love for them to learn this in Paramedics school... I personally believe there should be an essay question on the NREMT/P test stating describe the Kreb's cycle in no less than 250 words.... R/r 911

26! Do I hear 27? Anyone? 27? Anyone? Bueller? Bueller?

I personally have not seen telemetry used since about 1978 and that was for a demonstration purpose only. In the region telemetry is taboo and thought as a waste of money. If your medics can not read and interpret rhythms, it is time for some new ones... R/r 911

Actually license and certification are two different things and the best explanation is found in the EMS Scope of Training proposal and entitles more than some are aware of. That is why progressive EMS personal want license NOT certification levels to be our representative levels. Here is a link to that site : http://www.jems.com/data/pdf/SOPFinal4.0.pdf Please refer to page(s) 12 -14 All people involved in EMS needs to be aware of the correct definitions. The difference is certification is just stating you have received achievement of passing and having the minimum, proficient level and have minimal competency level. License grants permission to an individual from a State to perform specific restricted activities. The States has the authority to manage those activities. License level is held more accountable than being certified and just having met the minimal standards. That is why professional ratings are license not certified.. i.e physician, nurses, pilots, engineers, etc.. again certification is just describing you have passed or met the lowest criteria allowable. There is no down side... period. If one really knows and is aware of professional standards. Unless, you want EMS to continue to be considered non-professional, more of a organizations of skilled technicians. I and some other dedicated EMS professionals fought hard in the early 80's for our State to have license NOT certification. This has been easier to monitor personnel, be sure that one adheres to local, State guidelines and statutes and ability to revoke if needed. This as well brings the professional level and image among other health care peers to the same standards. Any State that is not considering is foolish, as well, certifications in the Courts eyes are not usually as well favored and sometimes considered non-credible. Remember we can certify anyone in anything as long as they met and passed the objectives. R/r 911

Yeah, bad situation. Very experienced ER Doc; however, I think he just wanted to practice. Although, each of 20 ER Cardiac rooms has EtCo2 (even with sideline) most of the Doc's are not real familiar with waveform interpretation. I do believe after this event they will be. :wink: Will see how much caa....caaa will proceed after this. No one is blaming the medics or making such reference. In fact it has now been one of those hushed things..... R/r 911

Good example, was called to ER .. medics was about to explode. Crew brought "respiratory arrest" in. The usual yadda.. yadda... good lung sounds, no abdominal distention, excellent wave forms on the Et C02 monitor with good levels for a bad patient. Crew prints out strip as per new protocol just before moving patient. ER physician looks at patient, listens says " sounds great".. makes about 10 steps.. stops and says "We need to re-intubate, that is in the belly".. WTF ? Crews reemphasize that there was good wave form, good lung sounds.. etc.. he then attempts to reintubate, and takes > 20 minutes, meanwhile patient codes and patient dies. Had to go diffuse the situation... We requesting the medics write a formal complaint and incidence, as well as we will show proper documentation of proper ET placement. Wonder if these type of incidences ever make the journal?..... R/r 911

Can I join, too? This looks like fun! -be safe.