nypamedic43

I was really lucky when I graduated from medic school. The night I passed my test, I was offered a part time position at the company that I did my ride time at...the same company I am with now. After 2 weeks of part time, a tragic accident led to the full time position that I have now. 5 days a week...no nights unless I pick up an open shift, benefits, vacation and time off whenever I want or need it. The pay isnt awesome but its more than 10 bucks an hour. Keep trying and keep your chin up. Something will come up for you

In the US, EMS systems have protocols and standing orders. Just because you've been trained to give a drug doesn't necessarily mean you will be able to give it, for 2 reasons. First reason is if it isn't in that regions formulary you can't give it and the second reason is if the Medical Director says you can't give it...you don't give it. I have given a couple drugs that are not in our formulary. I had to have written orders and written permission from my Med Diretor. I then had to go to the hospital pharmacy and personally sign for the drug and was told that if I didn't use it all, it had to be turned back in, which is a given, I used it all so I didn't have to worry about that. But it was a HUGE hassle to GET permission in writing. And I got a stern talking to when the orders were written. Not because he was afraid I would do something wrong but because the drug was unfamiliar to me so I got the run down on effects and so on. EMS in the US is a whole different ball game than what it is in the UK. Good Luck!

For the first time in a long time....I have no words to describe how I feel about these 2 stories, without going off on a complete tirade. It's best I just bite my tongue and go find my heating pad for my shoulder.

wow! that was quite the tirade LOL!

We don't carry narcotics on our person. They are behind a double lock, meaning they are locked in a box which is locked in a cabinet as per law. The keys are kept on our person while on shift and locked in a box in station when nobody is using the ambulance.

I also have been down this road...more times than I care to count. When I was younger I would get cluster headaches because of eye strain from reading alot in high school. As I got older they seemed to subside in frequency for a number of years. Then I go into medic school...with TONS of reading and they started to come back with a vengeance. So I went and had my eyes checked and changed my glasses ( I now wear wear bi-focals...no snickering Dwayne!!) The headaches havent decreased at all since I changed my glasses. However, I can tell when I have one coming on and I try to catch it quickly. I take an OTC migraine med and have a cup of coffee. Between the 2 of those, I can usually stop it before the nauseating pounding really starts. Sound bothers me more than light does and when I have a headache and the pager goes off, it's like someone takes an ice pick and stabs my head repeatedly, kinda like the shower scene in Psycho. I had one the other day that I didnt catch in time and sat at the desk at work with my face in my hands, ballin like a baby. I feel her pain. I know it isnt easy for her...or for anyone close to her to just sit and watch. And its frustrating when the meds you're taking dont work well. She might also want to dig around in her family history and see if anyone in her direct family (parents, grandparents, siblings) have them. My Dad has them as did my Grandmother...and I have, unfortunately, passed them on to my son. My borther gets them and so does my neice. I read Dwaynes article. It's interesting. If you click on the hyperlink for migraines there is an herb thats mentioned that has a side effect of headache...imagine that lol. I hope she finds an answer soon and finds some relief.

Josh was originally from here in Elmira and graduated Corning Community College with his paramedic and took the class at EMSTAR, where I took mine. Rest in Peace Josh. Thoughts and prayers to the family.

I've never tried flipping it upside down. However I have noticed that if you dont use the proper size cuff it can skew the readings.

As I stated in my previous post, you have 2 ways to learn while in medic class. Dwayne has summed it up rather well and all the replies here have said basically the same thing. If you want to test and get your certification, you have to stop this habit now. The result of reading more into the questions than is needed or trying to make it what you want it be, will be more than painful, it will be devastating. SO....stop it now. Be the Little Engine That Could. I think I can I think I can....I know I can. Dont make me come to Georgia and kick your butt

I LOVE british humor. And Dwayne...its feckin hilarious!!! Now I must go dry my eyes and wash my face...think I'll check my knickers too LMAO!!!!

Denny I'm not trying to beat you up for your post. However, that being said, things like neglect and abandonment, duty to act and scope of practice are covered fairly well in the basic class. They are then beaten into us in medic school. The Good Samaritan law is mentioned but not really gone over in depth. Our job is so much more that just throwing a patient in the back of an ambulance and driving them to the hospital. As you gain experience and run a few bad calls, or even a few good calls, your understanding of what this field really entails will become more clear to you. You will also realize that you are going to treat your patient to the best of your ability...regardless of who is looking over your shoulder.

First you have to actually neglect to act or actually abandon the patient to get those kind of legal problems. I dont know anyone here that would do that. It also doesnt matter if they are a healthcare professional. If a doc or a nurse or a PA or NP shows up on scene as a BYSTANDER, they cannot say how a patient gets treated if it is out of my scope of practice UNLESS they are willing to follow through with said treatment, ride in to the ED with me and take full responsibility for said treatment., explaining to med control why they deemed it necessary to supercede my authority on my ambulance and start a treament that could possibly have waited for 10 minutes. On top of that, bystanders can be utilized for help with carrying a patient or CPR. They are protected under the Good Samaritan Law. Doctors and nurses call ambulances just like us regular people do. And for the record I have pushed the nosy neighbor doc out of the way on a scene before and it was just this last week. Had an unresponsive diabetic, talked to the husband, let him know what I wanted to do for his wife, which he was in agreement with. I checked her BGL with my glucomenter, turned off her insulin pump, started a line and gave her an amp of D50. All of a sudden theres a ruckus on the steps. The neighbor, who is a doctor, and his wife came thumping up the steps. Demanded to know what I was doing for her and THEN demanded that I take her to the hospital. Oh NO you didnt go there....So I politely explained to the nosy neighbor doctor that it really wasnt any of his business what I was doing and that discussing my treatment plan with HIM was a violation of the HIPAA law and asked him to please remove himself from the room before I called the police. He left...in a huff, muttering under his breath that he was gonna call my boss. Anyway, by now the patient is waking up. I rechecked her BGL which was coming up well. She was able to talk to me and understand what I was telling her. I rechecked it again and by now she is fully coherant and refusing to go to the ED. I explained that she needed to eat something, call her personal doc and blah blah blah...DC'd the line, put a bandaid on the site, sign here, have a great day and if you need us, call us back. Pediatric patients under the age of 5 have a parent ride in the back with them. Other parents can ride in the front. I havent ever had a parent try to direct my treatents of thier child. But I always listen to them to. We have a couple kids in the area that are super sick all the time and Dwaynes description of a scene is pretty accurate for them. The parents are know whats going on and how to treat it and usually when these parents call, its because something isnt going the way it should and they need some extra help. Thier guidance and advice is most valuable in this situation. I have to say there have been a couple of times when I have allowed significant others ride in the front and they try to tell me what to do from the front seat. They are politely told by my partner that it isnt a good idea because A. they arent married and B. we are allowing them to ride as a courtesy. Oh and the nosy neighbor doc did call my boss. I had already told him about the incident and he was aware that he may call. So when he did, nosy neighbor doc was again politely told that it wasnt any of his business and next time to stay out of the way.

As a student I was confused by this as well. The course was taught by what the state wanted and we all had problems with that because we wanted to do what our local protocols wanted us to do. The 2 are incompatible. Then add ITLS, PALS and ACLS on top of that, who all wanted us to do what they wanted. It makes your head spin. The bottom line is you have to throw out local protocols and in some cases the state ones as well. THEN once you pass your paramedic and get certified...you go by your local protocols and what the other classes want. I don't envy where you are Brett, I've been there and would rather go to the dentist than go through it again. Here in the region that I am in, in order to pronounce a patient dead, there has to be signs of injury that are incompatible with life and then we have to call medical control. Crazy huh? I would love to see a national standard but I doubt that it will ever happen. Too many states want it done thier way or will change things at the local level. It all depends on your Medical Director and what he is comfortable with EMS doing on his license. If he wants a phone call to pronounce someone, that is what he/she will get. Regardless of what the state says we can do. I agree that the instructor could have handled the question better however he is going by what the PHTLS manual wants him to go by. We may not agree with it and argue the point but he is teaching what PHTLS wants and not what the state or local region wants. And for the record I wouldnt have worked this patient. He is dead and I cant fix that.

It was hell on earth for me because, even though I am married, my husband is an over the road truck driver. He was gone, at that point, a month at a time. i was trying to work full time, go to school full time, be a full time Mom and take care of class and clinicals and the house and the bills. I was also dealing with a new diagnosis of autism for my son. Was I stressed out?? Juuuust a little bit. On the family front, I was still trying to deal with my mother's death and THEN trying to deal with my father's new girlfriend (which still isnt going so well). My great Aunt passed away right after class started, then my cousin and then his father. But I kept it together, stayed in class and fought through the depression and grief. I dont think I did too bad. I graduated in the top third of my class, got hired at the company I work for now the night I passed my test ( which was really wierd at the time) and got totally obliterated with my class that night. I was talking to my boss after I got a subpoena to show up for court. He said that he fields lawyers phone calls for intent of legal action by patients on a daily basis. Most of the time, his lawyers go through the tapes and the PCR's and find nothing that would warrent a civil case, let alone a criminal one. I am not saying that I worry about being taken to court. I am just saying that the possibility is real. Does it change how I treat patients? No it doesnt. They get the best that I can give them. I make my treatment plan, follow through with it and am prepared to defend it to my boss and my medical director. Our job isn't tough but there sure are alot of inner workings that people just do and dont think about. PR, counselor, teachable moments and peace maker are a few off the top of my head.

No I don't think I'm laying it on a bit thick. I'm being as honest as I know how to be. No this job isnt tough. Its challenging. As for doing jail time for a mistake? Yes it can to happen. Being taken to court for misconduct or a mistake that causes a death and the family makes a civil case is a very real possibility. Does it happen often? No. But it can happen at any time and for any reason. We all advocate for our patients and do the best we can do for them. But do not think for a second that a "mistake" can't cost you everything. If its pursued strongly enough, with the right lawyer, it's very real.

Requesting information through the Freedom of Information Act can take weeks. I am truly unimpressed with the fact that they may be famous. They put their pants on one leg at a time, just like I do. They should be covered under HIPAA but usually that kind of thing is reported in a very short time. Quite honestly I could give a rats ass that Demi Moore is having health issues or that Heather Locklear just got out of rehab. These things truly fall under the "who" category for me. However with all that being said, their rights should be protected just like yours or mine should be.

Good luck Mike!!

Well let's see. In order to get through class, you need to not have a life at all and dedicate every free moment to studying and clinicals. Once out on the street, you must be able to take charge, think on your feet, think outside the box and do what needs to be done, remembering the whole time that, if you screw up? It's your job, your house, your boss's house and life, your partners house and life and possible jail time. How does it sound so far. It's stressful and mentally and physically exhausting and when you get off shift you still have to take care of your spouse and kids and house and bills. If you think we make a lot of money....think again. But then we don't do this for the money...right? We do this job to help our community, family and friends in their time of crisis. We dont take care of ourselves, we eat poorly, don't exercise and sleep a lot when off shift....because we were just awake for 33 or 48 hours. We do this job to be bitched at for taking too long to get there, for not doing what "they" think we should be doing and complained about when we do do what we should be doing. All of this for the once in awhile "Thank you" and an "atta girl or boy" for doing a good job. All the while stinging because we gave D50 to a 17 yr old instead of D25 or gave albuterol/atrovent instead of JUST albuterol. Still want to be a paramedic?

This has been a really great learning experience for me. I didn't post the article to start arguments but the replies and studies have been very educational. I never really thought about it before, but I am now

HAHA!! I have one as well...yeah I have auto correct fails everyday

Socialist or specialist? Google is your friend...this link is one of many to colleges that offer this course. And it is ADDITIONAL to being a paramedic. https://go.dmacc.edu/programs/health/paramedic/Pages/aasdegree.aspx edited to add link .

As island pointed out, if the internal defib has been deactivated by magnet, the heart is under its own power. I am going to guess that it was the patients wish, as they are going home on hospice for end of life care. As for the PEA (pulseless electrical activity) , regardless of whether the internal defib is active or not, the patient can still go into a PEA. What this means is that the heart (or internal defib) is producing the electrical pulses it needs to make the heart pump....but the pump isnt doing what its supposed to be doing, pumpng.