akflightmedic

Who else is going to do it? Do we need to hire billers for all our trucks? Get real. Grow up..its a simple question and its one that is expected with any medical service that is provided.

Myabe its just me, but what is wronk with asking? I don't get it. You open your mouth, ask the question, get your answer and move on. They will not be insulted or offended, so why are you? Its simple, Do you have insurance for which we can bill for sevices rendered. If they say no, you then ask what about the 'caid? Geez, we ask patients anything and everything about their deepest darkest medical secrets, yet we cant ask a simple do you have insurance question. You think a person is more likely to tell you about their veneral disease rather than what type of insurance they have. Get real! Why is this a hassle? You go to the docs office and they ask for insurance, same for the dentists office. Are you offended? I'm not, and I wasnt even offended when I was on medicaid myself. Even in emergency situations, they ask you about insurance. Yes they treat you or stabilize as per the law, but as soon as you are concious or able to sign, the clerk is there getting a signature and asking about insurance. We need money people!! Why should EMS services be free when everything else is paid for? You want better salaries, newer equipment, paid staff??? Then bill for your services.

Prehospitally, if you need an IV that bad and you can't locate a vein, then use th EZ IO. Wonderful tool, works wonders. Just got it this year and wish I had it for my whole career. I think of all the people that could have benefited from it and it amazes me.

I already covered this a few months ago. Maybe you will get more responses than I did. http://www.emtcity.com/phpBB2/viewtopic.ph...&highlight=

Japan's paramedics in a straitjacket On April 1, Japanese paramedics will take a small but significant step toward catching up with their counterparts in the United States and Europe: For the first time in their brief 15-year history, they will be allowed to administer a drug, the heart stimulant epinephrine, though only in cases of cardiac arrest. Hopes are high among many ambulance workers that this will pave the way to the expansion of their role in emergency medical care. However, in the absence of any widespread public concern, the government has shown little sign of making further legislative changes or resource allocations in this direction. The Japanese public, on the whole, is blissfully unaware of just how limited the scope of its emergency medical technicians is by the 1948 Medical Practitioner Law under which they operate. Recruited, trained and employed by fire departments of local governments, most Japanese paramedics were previously firefighters, and are still regularly rostered for firefighting duties. This accords with the fire authorities' traditional view of the primary role of paramedics as being to provide an emergency transport service to hospital. "In principle, paramedics are firefighters," in the words of a Tokyo Fire Department spokesman. Yet today, emergency calls for ambulances far outnumber those for fire engines, as the incidence of fire has, thankfully, peaked. However, traffic congestion is causing ambulances to take longer to transport patients to hospital. In Tokyo, the average time taken is 40.4 minutes, well over the national average of 29.4 minutes -- and this is after taking 6.3 minutes, on average, to get to the scene of an emergency. Clearly, this is all the more reason for expanding the role of ambulance rescuers, re-establishing them as full-fledged medical technicians capable of performing a broad range of emergency medical treatment in order to save more lives. This is the norm in developed countries, and doctors say Japanese paramedics were created in 1991 with this objective. Over the last 15 years, however, it appears, minimum efforts have been expended toward this goal. Until three years ago Japanese paramedics weren't even permitted to use defibrillators without doctors' supervision -- via the phone. "I know of many cases where lives were lost while waiting for a doctor's approval," says an emergency physician at the Nippon Medical School Hospital in Tokyo. A one-minute delay reduces survival rate by between 7 percent and 10 percent, he says. New legislation has removed such restrictions on using semiautomatic defibrillators and, from April 1, on administering epinephrine for resuscitation purposes only, and not for prevention of heart failure. Even if paramedics see the danger, current law dictates that "they must wait until the heart stops," says the physician. Insertion of a tube through the mouth of the patient is now allowed, without a doctor's approval -- but only when breathing stops, and not before. Resuscitation is all that emergency technicians are allowed to do. Anything more such as alleviating pain or discomfort or performing lifesaving preventive procedures is classified as "medical practice" under the 1948 law, and as such remains the exclusive domain of qualified doctors in Japan. That same Medical Practitioner Law, which long predates the existence of paramedics, also prohibits anyone except doctors and nurses -- and in exceptional cases patients' families -- from using a syringe. In the July 7 London bombings, British paramedics were the first ones on the scene, injecting painkillers and feeding fluids through intravenous drips to critically injured victims as they lay in underground tunnels waiting to be evacuated. Japanese paramedics would not be allowed to do the same; nor would they presently have sufficient training to do so. Retraining programs seem to be taking longer than expected. Nearly a year after the latest legislative change, only 51 of 1,500 paramedics in Tokyo are certified as qualified to administer the heart stimulant epinephrine starting April 1. Authorities say their resources are stretched. However, if the government's aim is to have paramedics of international standard in this country, resources must be found -- and quickly -- to give all Japanese paramedics world-class training. In the meantime, in order to maintain uniformly high standards, the recruitment and subsequent career paths of paramedics should be separated from those of firefighters. Clearly, the aptitudes and skills required for fighting fires and providing emergency medical care are poles apart. Currently, Japanese paramedics are wearing both hats -- with increasing difficulty.

WOW!! Is that an Ace post?? I am impresssed! I think that is the shortest, nicest and to the point post ever posted by Ace. Me thinks someone is shooting for different nominations in 2007...lol. How funny is it that a newbie called out Rid...some people have no clue..that gave me a good laugh as well. Not only can the nebie NOT defend his flawed argument, he can not even spell EVOC correctly. I would like to touch on the comment he made with due regards to safety. He said look right, look left and proceed. I think he is the one viewing it from a narrow perspective. How many accidents ocurred that you did not see? They do not have to involve you. You can not control what other drivers will do. I have had people pull over or in front of other cars because they thought they were being helpful and trying to get out of my way. I felt bad for them, because only if they knew I was repsonding to total BS, they would think differently about L n S. For the record this was an old system that required L n S on everything. My last system was great with priority dispatching..and the strange thing was..it worked!!! Very rarely was something more serious than what we thought. But I hate the argument of what if it was your family, what would you want or do? You know what? It doesnt matter..IT IS NOT MY EMERGENCY!! Say it again, IT IS NOT MY EMERGENCY!!..Yes it may be a loved one, and I would be sad, but who are we to think first, that we are entitled to instant EMS, and secondly to think that we could and should cheat death at every opportunity. Death is natural, it is an integral part of living. Get over yourself and your heroics....

I am afraid you will be out of luck for quite some time. As for your current certification level, there is no need to have you onboard an aircraft. Some rotor programs allow observers for a few hours or a shift, but this is very rare. There is too much liability to have a non employee flying along. There are also weight considerations that must be figured in. Heavy pt or two pts and guess who will be left standing on scene as the bird leaves. You will not be allowed to utilize your skills in a helicopter, which is crowded to start with unless you fly in the big monsters like me. The programs that I know of that do allow observers, require that the observer be in the local area EMS profession. As for fixed wing programs, with the exception of remote Alaska, Canada, and the reservations in AZ and NM, very few flight programs do emergency response with a fixed wing. This means that the flights most fixed wing programs perform are non emergency in nature, just requiring specialty care or treatment and/or the pts are being repatriated. This is one of themost common flights. As for having riders on these flights, I have to ask you..Have you ever been inside of a Lear jet or KA 200? These are the most commonly used aircraft for fixed wing. They are cramped as well. Usually only one caregiver has direct access to the pt in a convienent fashion. Having a 3rd person on board, again adds unecesary weight and basically you will be in the way. In addition, a lot of these flights are very routine and mundane as they are not usually trauma in nature. My advice to you is to continue on to paramedic or nursing, get a few years experience and then start hitting the programs hard. On average, it takes a minimum of 3-5 years busy ALS experience before most programs will even consider hiring you. Good luck with your endeavors and if I can provide any more info, ask away.

Emergency Responders Stretched Thin (AP) _ The head of Emergency Medical Services in North Dakota says the workload has increased but the number of providers has remained the same or dropped. Tim Meyer says rural emergency service operations are struggling, with nearly 20-percent of the volunteers over age 60 statewide. He also says the services in the western part of the state have quite a distance between towns. Meyer sees more consolidation to provide 24-hour service. He says the state has 65-hundred emergency service providers, with 90 percent of them volunteers. He says they handle about 50-thousand calls a year.

The next generation of super jumbo jets will need a full-time medic on board, the Royal College of Nurses said today. Rita Mody, a committee member of the college's In-flight Nurses Association, said the move is needed to make sure people who fall ill can get care immediately. Statistics show that one in 1400 passengers have an onboard medical emergency and eight per cent of those incidents result in an unscheduled landing. Ms Mody said the high numbers of passengers that can be carried on Airbus A380s will lead to a "high probability that someone will fall ill". The Airbus A380 is the world's largest passenger plane and can carry as many as 840 people. Virgin Atlantic, which is putting the A380 into service in 2009, said its staff had extensive medical training. A spokeswoman said the airline planned to board no more than 550 passengers.

Thats what I miss about FL. We routinely intiated NTG drips, glass bottle and all. After doing that for several years, I got lost in my own little world and didn't realize hardly anyone else was doing them. Oh well, I will be back there soon enough....

Why would it bother you? Let them do it, who cares. Where I worked, we utilized communication. The IC for the fire department would tell us his plan and how it may affect the pt as far as movement wise. He would even ask if it needed to be a quick get em out by any means necessary or does he have time to do this or that. It worked great. If the pt was accessible, a medic was inside the car at all times. The medic had the safety sign that would stop all extrication, movement, whatever should that become necessary. The medic is also outiftted with protective gear. As soon as the pt is accessible, the medic was the ones to lay hands on the patient. All is takes is teamwork and communication. Let them cut away, thats what they are there for...cutting cars, carrying my patients, doing compressions, fetching equipment, blocking the scene with their big truck, and occassionally putting out fires.

No, but I can say HIPAA Sorry pet peeve of mine...we can not even spell the name right...

Well the subject got a little off topic. It is a free/paid argument. I have not questioned the level of care provided by vollies. What this thread originally was about is what is best for the community and how vollies continue to take jobs from paid guys due to their kind heartedness. Vollies can be used to augment a system as Dust said, but they should never be the sole providers. Step back and look at the big picture, dont allow your feelings or ego to be insulted. Statistically speaking, which is better for a community? Which would you rather have in your own backyard? A system in place that is ready to roll at a moments notice or volunteers responding from who knows where and how long. Volunteers can not be held accountable for slow response times or failure to maintain training standards unless the administration self imposses that which is rare. After all, they are volunteers donating their time and services..if you dont like it, they will quit..and we can't have that cause that would mean we would have to start our own system. Who does the checks and balances on the system? We have talked many times on this site about how to get the pay we deserve and elevate our positions to one that deserves the respect of our peers. If we continue to give things away for free, the town, city, whatever will continue to abuse it and stuff the money elsewhere instead of the EMS system where it should be. The money is out there. There are federal and state grants for this sort of thing. However, this argument is a moot one due to the nature of EMS. Volunteerism is on a decline and with the increase in education standards, it will all fall to the wayside in a matter of years. Then maybe we will get the pay and respect we deserve. If they would hurry up and enforce the college degree reuirement in EMS, we could elimate 99 percent of the volunteers and start demanding higher wages. If I sound bitter, it is because I do like to help people, but I also need to get paid. IN 12 years of doing EMS, I have NEVER worked only one job or turned down overtime opportunities. It wasn't just me either, cause I tend to live beneath my means. As I looked around at all my co-workers, they too were working multiple jobs and/or returning to school so they could afford to live. If there is anyone on this site that is a full time paid EMS person and only works one job, please make yourself known. It is a rarity I assure you. Even EMTCIty Admin has a second job..this website.

Correct me if I am wrong, but the guard and reservists collect a paycheck when on duty and when activated...

They are beginning to realize it is a losing battle..... MOUNT OLIVE -- Rescue volunteers are still answering calls when the alarm sounds -- when they can. They're also meeting and competing -- when they can. Their numbers are fewer today, and the meetings are less formal, said Mount Olive rescue volunteer Debbie Hennessee shortly before she became the first woman to receive a lifetime membership in the squad during a recent meeting. She has been a volunteer for 20 years. "We're small in number now, but we're really big in heart," she said. "It's not just the individual who touches rescue. We know it takes the entire family. Alone we could not do what we do. I used to ride all the time, and I had a very understanding family." She told the story of rescue wife Grace Lane, who would get the boots and gear ready for her late husband, Dempsey, when he responded to calls in the middle of the night. Employers used to help, too. Older volunteers have said employers used to let them off work to respond to calls. Back in the late 1950s when the Mount Olive squad began, the volunteers depended on the local funeral home for some of their transports to the hospital, especially when there were more than one or two injured, until the early '60s when they got their first ambulance, a Ford truck the squad still has. "It evolves. It changes daily," Ms. Hennessee said. "We've seen a lot of changes through the years, but there is a lot of honor and a lot of dignity on these walls." But today, the volunteers have to ask permission from the paid emergency medical technicians to use the building. And since Wayne County took over operations of EMS with paid staff, the other trucks have been dispersed throughout Wayne County. The volunteers have fond memories when they see the yellow trucks. "We think about the joy and the friendship we had when we see our truck on the highway," Ms. Hennessee said. The Mount Olive volunteers were highly respected throughout the U.S. and took home many championships, said Buddy Shaw, who installed the officers. Shaw said he got into rescue one year after the Mount Olive squad was organized. He's been in rescue ever since. "People ask what happened to Wayne County?" he said. He said he has nothing against paid EMS workers. "There are things they can do we can't, because the volunteers can't get off their jobs." He urged the volunteers to not give up. He said he doesn't think their role will ever be what it used to be -- including the old days when $6,000 would buy a truck. Today, that same vehicle costs more than $250,000. "There's no way volunteers can keep up with that," Shaw said. "Not enough turkeys and pigs can be killed to keep up with that." It's becoming more difficult to be a volunteer, but he told the Mount Olive rescuers they can still go out into the cold night and hold somebody's hand on the way to the hospital. Sometimes, years later, that same patient might come up to his or her rescuer and say "thank you" for the care he or she received. Shaw said it has been the thank-yous that kept him going through the tough years. Dempsey Lane's son, Jerry, said one of the reasons he joined the Mount Olive squad was the kindness the volunteers showed his wife's uncle. Brenda Lane's uncle, Bill McCullen, had a heart attack. "The rescue people showed up at the house" Lane said. "They fought a valiant fight to keep Mr. Bill alive." McCullen succumbed to the heart attack. Dempsey Lane went on to become a state EMT examiner. Even though they understand the changes might be necessary, the volunteers say they will continue to serve where they can -- and be proud of their accomplishments. "I don't know why decisions are made to change things. I guess that's progress," Lane said. "It takes a lot of training to keep things going now. I can remember my dad sitting over there studying for the EMT exam. When he passed that thing he was so proud of that." That is a legacy his son says he will continue by helping others to achieve the same goal.

I am now wondering who my first victim will be and what types of victims should I select....Any advice

Professional Services means to be paid....not the level or quality of care although it is historically better when one is paid. Volunteer means for free. That is what he meant by that statement.

As I stated and someone else did before me, there are very few areas left that need a vollie service. Yours may be one of them. But I assure you if there was no ambulance service provided in your area, Rural Metro or AMR would find a way to be there overnight. But to further touch on your statement, you imply that there is not a significant tax base to fund a service. Not true. I know of several systems that are a conglomerate of different counties or towns. They pooled their resources to make it happen. It is doable. Volunteers are dwindling, so you need to make preparations for the days when there are not enough to help you when you have the oh so dreaded heart attack. I had personal experience with an all volunteer area. During hunting season you could forget about getting help or manpower in a timely fashion. It was awkward never knowing if people were actually coming. Just because you call doesnt mean they are coming in a volunteer system. We would end up with 20 people on a stubbed toe and 2 on a cardiac arrest. This was not only observed with this particular organization but many systems that I have been around. What I have observed at every volunteer station however, is there is one core group that keeps the place afloat. These die hards make it work, which is wrong, because then they start planning their life around the volunteer system. Eventually they have no life because "they are needed". If they didnt do it, no one else would. It is unfair to these people. Eventually, they burn out. Then you have lost the core. What do you do now? As for the standards of the vollie agency, I always had plenty of people willing to drive. When it came to furthering their education, they werent interested. They felt their being there and helping drive was sufficient enough. Continuing education was a joke, as well as training nights. You can not say this was limited to one area or one agency. I witnessed this behavior in 4 different states and in about 15 different agencies. It was the same in SC, FL,LA, and Alaska. Different place, same story.

If everyone that was able to... fostered a child, we would have no kids without the love of a family filled a pothole, all roads would be smooth hauled their own trash, we wouldnt have noisy trucks in our neighborhood at 0700 on our off day But you don't see any of these things being done by volunteers. They all collect money for their services. I have fostered, I know. the state paid me monthly. It didnt cover everything but they did pay. EMS needs to be a paid profession. Not saying volunteers are unprofessional, but saying it needs to be paid. There are very few areas left that do not have the tax base to support a paid service. Why do towns and cities not go paid? Because there are volunteers there that have always done it for free. They sure seem to have the money to pay garbagemen and road crews, so why not EMS? A paid system could allow vollies but the local EMS system should never rely totally on them. What happens when the pool dries up, or people are just away because they have a life? This is not an issue of paragods as mentioned. The paid system could be all Basics for all I care but at least it is a system set up and in place...not people responding POV from home to the station or to the scene. As long as we continue to do this, we resemble a bunch of Ricky Rescues and shortchange ourselves in the eyes of the professional world. I like helping others, that is why I tolerate the low pay...but, I do need to be paid. I got to eat as well. And volunteering is not about being all helpful and doing the community a service, people volunteer to feel good about themselves. Look up the definition. People brag about their vollie affiliations cause they look better to other people. It is all about stroking your own ego and making yourself feel good. If you didnt feel good after doing it, you wouldnt do it in the first place. I am not saying all vollies are of this mentality, but think about it. If no one volunteered, they would be forced to implement a paid system. That would do several things for your community you care so deeply about. First, it would ensure rapid care at all times, second, it would create jobs for your town.

More than a dozen Portales police officers and Roosevelt County sheriff's deputies borrowed an ambulance to swoop down on a county residence and serve a search warrant. They came away with three arrests and $1,700 worth of suspected methamphetamine. The bust happened this week after an informant gave authorities information on drugs and surveillance equipment in the home that was used to monitor police activity. Dispatchers put out a fake call for ambulance crews to respond to a neighboring residence. That provided cover for authorities to be in the neighborhood. Arrested were 38-year-old Armando Ontiveros, 22-year-old Juan Tovar and 31-year-old Anastacio Saenz Jr.

I can tell you a lot about it. What do you want to know as I have had personal experience with them as some of my old coworkers have as well. The pay is not great, you work 10, 12 or 14 hour shifts. They are system status..which means your entire shift is spent inside the ambulance. If you are an EMT-Basic, all you will do is drive as they require medics to ride in with every patient regardless of nature of illness or injury. They do not have a good reputation with the city FD, who has control of every scene until they turn it over to you. The FD will always be on scene a good 8-10 minutes before you, so if there are ALS procedures to be done, they will do them, plus they have the option of riding in with you and maintaining pt control. Orlando ERs are so overcrowded, you spend on average an hour at the hospital waiting to transfer care. ANything else, just ask.....

Therein lies the problem. Your last sentence supports what others have already said. It is all about YOU! It makes YOU feel good, its all about your ego. You say it is not anyone else's problem, but it is. You have made a decision for your community that they do no need full time ALS care. WHo are you to decide that for them? Also by volunteering, you continue to make it more difficult for the upcoming newbies to acquire employment in smaller towns or to even earn a salary they can live on because people like YOU continue to offer services for free. If you want to help, use your degree to implement a full time service that provides ALS care 24/7. Juts because you do not want to do it for a living and earn chump change does not mean some other people in your community feel the same. They might be more than happy to do it FT and earn a pittance, but you are taking that choice away. So, in retrospect, I guess it IS everyone's problem...not just yours. For the record, I started out as a volunteer and had many of the same ideas/arguments that you guys are presenting. I never understood why my service was being so heavily criticized by the paid guys. But once you make this your career and wish to see your career earn the respect it deserves, you need to make changes, drastic changes. If we are ever going to make the money we deserve and gain the respect of our peers, we need to quit giving it away for free. I never seen anyone respect a slut, until she cleaned herself up, quit giving it away, got educated and made something of herself. We need to do the same!

That's a question for the EMS bureaucrats of that state. When I applied for OR reciprocity, it took 13 weeks!! AK reciprocity took 8 weeks. FL reciprocity took 2 weeks. LA reciprocity was 1 week. It all varies by state of course but for the most part it is the background check that takes the longest. OR took so long cause they do a 50 state background check instead of only checking the states where you were licensed. They contract out the work so it was then out of their hands and in another parties. My advice to you is to call the EMS board there, they will answer your questions.

Baby Born at Colorado Fire Station OK Story by thedenverchannel.com A baby boy who was born Friday at a Poudre Fire Authority station and left there by his mother remains in good condition, said authorities at Poudre Valley Hospital in Fort Collins. A family has already asked to adopt him, and he has already been placed, said authorities with the Larimer County's Department of Human Services. "State law requires the Department of Human Services to place Baby Doe with potential adoptive parents as soon as possible. Therefore, as soon as Baby Doe is ready to leave the hospital he will be placed with a certified Foster-Adopt home, one that was approved by the Larimer County Department of Human Services some time ago," said Michelle Hostetler, deputy division manager of the Department of Human Services. "The people who will be receiving Baby Doe have received the training required and passed a background check, both required by law to become foster-adopt parents," said Tony Passariello, supervisor of the Permanency Unit at the Department of Human Services. The boy's birth mother walked into a fire station Friday at 8 a.m., and gave birth an hour later. She left the infant with the firefighters and paramedics who helped deliver the child. Since she invoked the state's Safe Haven law, which allows a mother to surrender her child to medical workers, a hospital or fire station within 72 hours of giving birth, the woman will not face any charges. This is the first time that the Safe Haven law has been used in Larimer County. Hostetler said it's a good law -- one that obviously helped a struggling mother. "What she did was an act of love. She could have given birth and put the child in a plastic bag, and she chose not to do that," said Hostetler. To learn more about the foster-adopt or the adoption programs in Larimer County, call (970) 498-6940.

I will let the others addrsss your questions for now, however the one piece of advice I will give you is NEVER, I repeat NEVER use your email address as your screen name. You open the door for spammers, attackers and the llike by displaying that information. You need to change your name immediately. If you can not do so by yourself, email admin and have him do it for you.