Ridryder 911

Sounds like a so called "nurse" (no-formal education required); got a case of law suit itits. Got jerky... going to a loca ER, the Doc;s would had probably told her of the dangers, or if she had a syncopal episode while enroute.. oops! R/r 911

There are a lot of us over there incognito... :wink: R/r 911

.. Almost pee'ed my pants !... Yeah, and the chances of that is higher than me winning the lottery on the first draw.... oh, if you believe being an EMT wil help you into medical school, then you would buy this slighlty used car..... only drove on Sundays by a little old lady... R/r 911

And EMSA "brainwashing".. They have some very good medics and some not so. The one of the major problems with EMSA is they indoctrinate that either it is the EMSA way or no way. Many of their personal can not think outside their protocols. Their protocol book is several hundred pages. Yet, their medical protocols is about normal and not really aggressive. Lots of P & P. Long term longevity is not highly promoted, but can be achieved once you "learn the game". I have several friends that work at both Tulsa and OKC EMS and we have several EMSA medics that have moved to our service full time but remains part-time. As well, Dr. Sacra (medical director) and I are professional colleagues and friends. Research in EMS is one of his forte. I always recommend EMSA if you want high call volume and improve on skills. If you plan to leave in two years, that is even better. You will have large metro experience.. if you are not too burned out, sitting in a truck for 12 hours. Be safe, R/r 911

The problem again is too many chefs ruin a good stew.. Sorry, we are a specialty already. As patient advocates are we not supposed to want the best for the patient ?.. Can you truly say, having someone with the ability to "push" the meds is the best ?. My daughter can push a syringe full of medicines.. even hook up a monitor, but apparently even EMT's are not aware, that AED' s only monitor 3 rhythms... and those are not the common ones. Seriously, we rather have a half ass system than to actually work on it and have the best ?.. No one can tell me if it is not the best for the patient, then it is purely simply for the ego of the EMT's.. Sorry, you can't interpret ECG, don't know cellular pharmacology, it is short and simple... you are not educated enough to make clinical impressions and administer medications.. that is why we don't allow nurses to do surgery, pharmacist to perform chest tubes.. because they are not educated in those specialties. Really want to push medications? It is simple . go back to school.. pass the boards. then there you go.. The afterward you will see what we were talking about. This is it for me.. this thread is getting boring and will not change anything.. EMT will still be looked upon as uneducated skill seekers.. unfortunately I guess their right. Be safe, R/r 911

Usually, it the flight crew I have found that has overinflated egos.. A nurse that doesn't think they can do no wrong, a paramedic that does not know if they did wrong, and a Pilot that does not know what wrong is..... :wink: After flying in both fix and rotor for several years.. I soon realized, that the jobs are the same. There was no difference except I can move around a hell lot easier and not have to keep watch for "heavies" and LZ's. Although I love flying, it is a wide misconception anything is "special" up there. Yes, you have to have more education on flight medicine but that can be easily learned. Emergency care is emergency care, no matter where, locality, or time of day. It does not matter which flight/jump suit I wear.. I am the same. R/r 911

Funny I always thought of the dumbest old city boys....lol Not trying to hijack thread, but when discussing rotations.. My program required 200 clock clinical hours in cardiology one on one with physician and specialty care 300 hours. They were selected ER physicians to do your internship with. Sorry, no EMT uniforms allowed.. had to be white lab coat, business dress (shirt/tie or formal dress) You were to be treated and have the knowledge basically of an intern. The student did the initial assessment and orders, then reviewed by physician. Great learning experience to think outside the box, you learn very fast we are just the tip of emergency medicine. Detailed assessments, wide knowledge base both pre-hospital and inner-hospital was expected. You did not proceed further until blessed by these Doc's. The Doc's now being used are former Paramedics, that have a very good working knowledge of EMS. Be safe, R/r 911

Sorry can't vote... won't allow me to vote for more than one... R/r 911

NP.. I can take a ribbing like anyone else. The problem is the vote is tied and as of yet.. there still has been no medical justification of allowing such. Again, we want to do stuff without paying hte educational dues. No, not a class that is based upon clock hours... Please, if your going to vote at least be able to defend your action... R/r 911

Okay, time to put your money were your mouth is.. medically defend the issue. Would any medical director really feel comfortable with administration of medication without cardiac monitoring ?.. hmm Call that ego or just good patient care ? ... R/r 911

I wish we could clear the air for a while and stand back and look things objectively. Ever observe grand rounds with residents?.. There really is a methodically to its madness. Just ordering a test is not good enough, why is the test ordered, the risks, the potential findings.. again the same is true when discussing medications the same should be going through every EMT and medics head for every procedure, tasks, and medications administered. In my Paramedic school we were required to make grand rounds with internist, to start having the in-sight to ask ourselves each time, each patient, each procedure "Am what I doing beneficial, pertinent, and possibly change the outcome in positive side and do I know the risks and can I handle such risks, before doing anything? Yes, these become split second reflexes, but each procedure and action should have merit. Just because one is "certified or authorized" does not qualify the patient the need to have it done. One should remember we should be "treating patients and their conditions meet our protocols, not have the protocols meet the patient". So many I have seen, establish IV's because "protocols".. and what are we going to do with this I.V. ? Most medics reply "I dunno know, it is in our protocols"... Hmm...... here is your Milk-Bone, s-i-t-.........roll-over.....Good -Boy! Ahhh....how well trained we are ! Procedures, even as simple as oxygen administration, should be known, how, why, and is it going to do good for my patient ?.... It is really a shame we are not allowed teach basic medicine to a profession that performs medical procedures. R/r 911

Go to WWW.NREMT.org obtain the patient assessment check list, maybe this will clarify each step. Scene size up is before even touching the patient. What are the dangers, to me, partner, patient. How many, what is the mechanism of injury, am I going to need back-up, Is there something wrong with this picture type feeling ?.... BSI ABC..of course is after you made contact with the patient: C-spine immobilization, Airway, Breathing, Circulation, check and treatment of shock Good luck, R/r 911

Is it just me or is this thread going no where fast... amazing the vote is pro EMT- I's administering it, but no major rationale as of yet. So what have we learned: Medications should be administered by ALS educated personal Medications although intent is good for the patient can be BAD! Narcan as benign as it seems, can be dangerous to patients Administering Narcan non-appropriately can be harmful to your patient, you and your partner Some EMT/I's on this site either can not logically debate on why they should be allowed to administer the medication, or have no backbone to debate it. Therefore we have to assume that they are whackers and want to "push" a medicine, so they have something more to do on a call. Be safe, R/r 011

Ditto.... never seen or heard any anecdotal stories. Maybe Spock can enlighten us, since he works with this probably more on a daily basis. R/r 911

First problem is realizing that IV is not a BLS. Do you realize by introducing fluids you are technically changing the homeostasis of the body ?.. Are the fluids really going to help ? ... Even in the case of the NTG, laying the patient supine the NTG is transient and will wear off. Trauma .. fluid resuscitation has been proven not to be effective, and if you are do need fluid resuscitation they need more ALS than an IV. There are only two criteria for IV's prehospital: introducing of medication and re-hydration secondary to hypovelemia. R/r 911

There are several posts regard to this, but the main points is general education. Really, reading. writing and mathematics.. on a collegiate level. Plenty of science core courses, will help you no matter which course you decide. Believe it or not these supplemental courses actually make medic courses easier.. having study habits and A & P increases your knowledge . So many jump into EMS and EMT courses without basic education thinking "I will get that later".. and never do or do many years later. Most do not realize, most universities have a time line (usually 5 yrs) on science course that has be to be re-taken, so you can see where motivation is important. Good luck, R/r 911

Actually, there are many that was never a "EMT".... We have several that never worked as a basic in their life...(approximately 1/2 of our staff) including me and that was 29 years ago.... So yes, we are aware of basic procedures but not everyone nor should everyone has to be a basic once in their life to be a good medic... R/r 911

Although, I may not agree with Dust's frankness.. he is right. We have been in the field long enough and worked with enough people, after a while we can judge character and intent. It is part of our job.. No we are not a bunch of old cynical old medics.. just seen it too many times before. He did not say you could not do it... just chances are, you may not.. Like him, I have seen hundreds or maybe even thousands of enter this field with intentions of going to medical school.. nursing.. even Paramedic.. etc..yadda ..yadda. The EMS bug bites them, they become engrossed in EMS that their priorities change.. along with personal life that may or may not accompany this life style (look at other personal posts or even peoples blog). I cannot speak for Dust, but I am sure he would agree, we wished we had a nickel for every "I am going to be a Dr. someday!, partner I have had. I can predict within 15 minutes if you will or not.. I am so far about 98% accurate. Many think it is being smart, educated that makes one go through medical school.. well partly..but the main point is the motivational drive. Without it .. you will never finish any education programs. Really, most will agree all courses can be conquered if the drive is there... albeit it may be tough. or even have to get a tutor.. but, if the drive is strong enough, you will manage. Myself, Dust and some others that have been in the field for a few years (>25) are not seeing anything new in some of the ideologies.. except, when we were younger there was no one to point it out to us. I wished I had someone to "wake me up " and told me to get my ducks in a row!... There are VERY few that ever enter EMS and progress into a physician. Most of the ones I have seen were medics that decided after several years later to become a physician, not the ones that wanted to become one before entering the field. In fact in my 29 years, I have only seen 3 or 4 in compare with the 60 or so that was medics prior to becoming Docs. Again, the motivation was to become a physician for many reasons.. mainly for increase patient care, financial, and career reasons. So don't take it we our trying to brow beat you.. just, like in the field or even in here we hear or see so many, with the same statements. Like he described "prove him wrong".... Good luck.. keep studying and go forward! R/r 911

Actually that is not correct, they can MANAGE respiratory and seizures, but not really treat them. Basically, non-ALS personnel is doing is preventing harm and maintaining homeostasis so life can be maintained as prior to the event. But, to actually treat the etiology, and stop the seizure activity requires medications and interventions the EMT/B, EMT/I, EMT AA, EMT/IOU, EMT/2B. A. P cannot . R/r 911

"The Me Syndrome " I too am seeing it mainly in services, both public, fire, etc.. The problem is neither employee on the truck is educated or professional, mainly they are in the profession for themselves. We have sent a a couple of people who biggest job, was working the machine shop or 7-11; and they went to a technology school for their ______hour class, or you have one that believes because they are pre-med (Biology degree) now have developed an attitude. Meanwhile, never really realizing they both look & act like idiots. You have one whom that has a "god" like syndrome, then you have the other that is realizing this is the best that life is going to be for them .... and hates life. Neither having been exposed to real medical care or the non-written rules of being a health care provider. Somewhere down line we have crossed the line of having confidence for competence to cockiness with incompetence. What I see continue to see is a lack of compassion. Compassion for the care to patients, compassion for the profession, compassion of wanting to be the best in their profession. It has been replaced with arrogance, laziness, and basically pure stupidity... and no were not talking test scores. So many of the newer people entering the profession, never really wanted to do this, this was either the fastest entry program or a stepping stone for another profession, and boy can you sure tell it. The problem as well is it just is not isolated to personal but now seeps over to patient care. Administration has learned to deal with by having cookbook protocols, computer PCR, and step by step policies. Administration is quite aware that both employees are short timers (<10years) and actually promotes it, to prevent an increase of wages, benefits, and promotions. As long as the procedures or tasks are accomplished, liability is reduced or prevented, all PCR is filled enough to receive payment ... they are happy! Most administration groups have the attitude they are paying you to perform a task..not to think. This same phenomenon has floated into the hospital arena as well. That is why the average age of the nurse now is 42. So many younger people entering find out it that it will not be about them... but for the patients. Not getting the " attention" they thought would be there, they leave. I have heard physicians say the same of even residents... usually they have too much financial involvement, but as well many are leaving, during residency . How to solve it ?.. I don't know.. is it misconception of what the job is.. or that is that.."a job/work?".. That it is about the patient, and the procedures and performance should reflect patient care not you... Part of the job is the ability "to work with others".. and do a good job... each time! I fear we have just seen the tip of the iceberg of the problems... R/r 911

Although, it is inexcusable that EMS personnel make horrible salaries, there are as many other health care workers that are comparable and even have a higher education requirement. Just like, all other professionals, student loans and grants, scholarships should be investigated. Good luck, R/r 911

Who knows how many acronyms we can get?... EMS, can dilute itself down more and more... instead of focusing and facing the truth of what is truly needed, we develop more and more dilutions. In this case dilution is not the solution, it would be interesting in seeing the cost of all these programs in lieu of educating EMT to Paramedics ? R/r 911

We have been using the "oxygen saver " model types for about 6 months and appear to be doing great. They are better than the ones we had, that really sucked the oxygen down. Link : http://online.boundtree.com/store/product_...amp;Prod=531501 Easy to use and light weight, we have placed one on each truck.. (we have vents as well). I used it last night on a CHF and did good enough not to have to intubate... good luck, R/r 911

The whole Basic EMT text (all books) is horrible. They all are written under a high school Freshmen reading level, (most are 6'th grade). How can we expect a general knowledge of EMS with such shallow and pathetic resources?. Be safe, R/r 911

That is part of the problem with medicine and especially EMS. Most do not know how to read a study and take at face value. It is a shame that statistics and Foundations of Research is not required in Paramedic school, so studies can be dissected and be really evaluated. Look at the mean number and the population (P) and the standard deviation etc.... The same being of : What type of patient criteria was used... down time.. previous cardiac hx., CPR how long ?.. etc.. What would be outcome would be without changes ? Who sponsored this research ? How active was the author in this research or where they more an editor ? Again, if this works ..great ! But, please no not accept any changes solely based upon a few research articles. Even that this was performed in multiple sites does not impress me... so was Bretylium, high dose Epi, and even the Amway suction unit.. Time will tell.. again, research physicians should be held accountable... they are not! If the course that they predicted does not come true, they should be held accountable. Whenever; we start having some re-courses and responsibility associated with "too good to be true" statements, then we will start having credible research publicaitons. R/r 911