Asysin2leads

I know this has been a topic we've kicked around the office a few times, teens being EMT-B's, 18 year old paramedics, and I've always been of the idea that its not a good idea to have people that young involved in prehospital emergency care. Explorer program, fine, ride along, great, but volunteering as an EMT-B at 16 and being a full, paid paramedic at 18? Just not a good idea in my book, I'm sure there are young people out there that are an exception, but generally speaking, that's where I stand. This link is a thread from a different site, the players are dopy sleepy doc, an 18 year old apparently firefighter and paramedic student. I'm of course my normal, charming, warm hearted self. Read the texts, the back and forth, and see if you don't agree with me that 18 is too young to be a paramedic. http://www.publicsafetytalk.com/forum/t556-p6-test-help.html

Oh, and they can't take a joke, either. Lighten up, Francis. And if you really want to play who's diploma is bigger, I got out of one of the few accredited paramedic programs in the country with an honors AAS in paramedicine, with a minor in having an f---ing sense of humor about myself and my job.

Geeze man, some of these salaries make me cringe. Granted, my cost of living is like %8000 more than everyone else, but someone's going to pay me $8.50 an hour to do what I so well?

What she said is all true. EXCEPT FDNY PARAMEDICS ARE EVEN BETTER!!!

Screw the baby boomers. As George Carlin said, a generation who's founding principle is "GIMME IT IT'S MINE!!!" Nothing worse than a sanctimonious overweight 50 year old with grey hair tied back in a pony tail. Volunteer EMS in a support role isn't a bad idea. Sometimes you will get the s*** hits the fan situation and you do need a lot of people with some rudimentary knowledge of basic first aid. It does happen. I believe also that EMS should be made into a profession on par with nursing or even such things as physician's assistant. I would much rather have an 18 year old high school student say "this interests me, I'm going to apply to college for it" than one who says "this interests me, I'm going to do an EMT-Basic class and drop the tuition equivalent on stuff from Gall's" EMS is certainly intellectually and physically challenging enough to demand a full licensed, educated, and trained provider. It's up to the American public to start demanding better prehospital care for it to happen, and slowly, it is happening. Once you see a family member get treated by a well trained and educated paramedic, getting an ambulance with anything less in someone's time of need does not make good press.

First we have to clarify a few things. When someone uses the term "vollie" to refer to an ambulance service in NYC, they mean a "voluntary hospital", as in a hospital that contracts with the FDNY EMS command to provide EMS in and around their hospital. There are a few true "volunteer" squads in NYC, but they do not provided a substantial augmentation to the paid services. The vollie hospitals do a lot to take away Local 2507's bargaining power, as the city could just pretty much dissolve us and give us over to the vollies completely. In terms of volunteers, I have always been staunchly against volunteer EMS. Volunteer services are good for a fire department, where a structure fire needs a large amount of manpower, but EMS I have always believed should be an extension of the hospital. You don't go into an ER and have 20 volunteer RN's jump on you, and I don't think the same should be true in the field setting. I think there is a role for volunteer EMS in rural settings, and in places like retirement communities, but if a town has a paid police force and a paid fire department, paid EMS should also be a priority. I break volunteer EMS down like this: 10% dedicated, noble people, 25% lights and sirens weirdos, 35% people with serious emotional and/or mental disorders, and 30% bored housewives.

I'm of two minds on this subject. One the one hand, as someone said before, the preceptor/student relationship makes for easy pickings and can rapidly get out of hand. On the other hand, the true red blooded American in me says that if lonely instructor A and lonely instructor B meet, and hit it off, and start dating and live happily ever after, and it doesn't interfere with their professional relationship, then F--- the commie pinko bastards who say they can't see each other. This isn't China! Love who you want, I feel no workplace has the right to dictate what I can and cannot do in my free time. Rid, I think your actions on the unwelcome advances issue was swift, decisive, and entirely appropriate. I'm glad to know there are at least some supervisors out there who are willing to put their foot down. However, I think the problem many times is many times with the student's behavior. If you have little miss big boobs batting her eyelashes at the preceptors for a better grade, how do you deal with her? That can be a MUCH more difficult situation

Too answer your questions, A. EMS is under the direction of FDNY. Some places are covered by hospitals and private agencies contracted with the Department. I'm not sure what their policies regarding ride alongs are. B. As far as I know, ride alongs are still allowed, but it can be a pain the tuckus to get the paperwork through. Go to http://www.nyc.gov/fdny I believe you can find observer information there. Right now I'm too lazy to look it up. Good luck.

Respond for a trauma, report of elderly male shot in face and chest. Second elderly male onscene, possible cardiac condition, PD is enroute. Acknowledge? http://www.cnn.com/2006/POLITICS/02/12/cheney.ap/index.html More proof stupid white men and guns just don't mix.

Dude, no friggin' mercy on these guys. I want them all duct taped to a tree naked by morning. Let's move!

Save these for the next time you have Mr. or Ms. Know it all bystander giving you a hard time when you're in the midst of a call. I found this on a guide to heckler's for comedians. Oh yeah, you should probably only THINK about saying these, not actually say them, unless you have a REAL secure civil service job. 'This is my job. I don't come into McDonalds' and give you a hard time when you're at work.' 'This is my job. I don't knock the shovel out of your hand when you're at work.' Usually to a woman: 'This is my job. I don't knock the dick out of your mouth when you're at work.' <------ Favorite!!! 'This is my job. I don't show up at your job and unplug the Slurpee machine.' To a woman: 'This is my job. I don't show up at your job and jump on the bed.' 'This is my job. I don't peer in the alley when you're giving blow jobs to transsexuals.' To a man: 'This is my job. I don't show up at your job at the sperm clinic and jerk the Playboy out of your hands.' I might use that one when I'm about ready to retire. It's a good one.

For me, the basics save paramedics thing pretty much irks me the most. "Are you sure you're allowed to be doing that?" is up there, when it relates to something like intubation or starting an IV, but knowing some people in this field, that's actually a legitimate question. "Trauma naked" works, as there are far too many perverts on this job. Seriously, we have people who's biggest wish for the night is that someone gets hurt enough so that they can cut their clothes off. Here's 40 bucks, go get a lap dance, and consider another career.

I guess I'm losing everyone here. Here's my point. If you have a sick COPDer, giving them oxygen will not hurt them. It is really not necessary for the average EMT-B to get bogged down in hypoxic drive and CO2 offloading when treating at the BLS level. I'm not saying that every COPDer who calls 911 is having an exacerbation of their COPD, I'm saying that if a COPDer is to the point of calling 911 because of their respiratory problems, generally they will require oxygen, panic attacks not withstanding. I think there are far, far, far, far, FAR more COPDers who have oxygen withheld by well meaning but misguided people then COPDers who have been harmed by giving high flow oxygen. Don't automatically give everyone high flow o2, if not for the only reason that its a waste of o2. Treat according to presentation, and if they present with dyspnea, give them the oxygen.

That's BS that someone didn't have enough backboards. You know what you do if you don't have a backboard? You put a C-collar on and hold manual stabilization alllll the way to the hospital. It's an accepted, though not common, practice.

Okay, maybe I tend to oversimplify things, but generally speaking, if a COPDer is to the point of dialing 911, don't you think giving them oxygen will figure into the equation somewhere along the lines?

I don't think there was anything really insulting in that episode. A medic not knowing how to bag a patient isn't an insult, it's shoddy research by the writers. The anesthesiologist's desire for self preservation isn't really an insult either, it's a valid point. In fact, I think it might make us look a little better in the old bravery category. As for House, first of all, he's House M.D. he can say what ever he want. Second, he was talking to a medic in New Jersey. Third, maybe he meant MEDIC SCHOOL, which is exactly what I'd be saying to a medic if they were giving a shoddy report as well. I think it makes us look worse when David Hasselhoff brings someone back to life with a defibrillator then hands them off on an NRB to EMS. Doesn't make us look real good when we can't pull that off in real life.

I don't know what books these skells read or what bar they go to and get these kooky ideas about CO2 and hypoxic drive and stuff, but really this crap about giving oxygen to COPDers is truly infuriating. COPD stands for Chronic Obstructive Pulmonary Disorder, as in there is a CHRONIC OBSTRUCTION in the lower airways. This is either caused by chronic bronchitis, where the alveoli get all plugged up with mucus, and emphysema where there is loss of elasticity of the lungs and death of the alveoli themselves, providing for less oxygen exchange. The net result of either is LESS OXYGEN is diffusing to the cells in the lungs. In other words, in their normal state, it is harder for the person to get oxygen exchange than the normal person, and in an exacerbation state, it is REALLY hard for them to exchange oxygen. So, for $1000 and the game, what could this person possibly need? Ummmmm.... OXYGEN!!! So take your CO2 retention and your hypoxic drive and all the other terms that make you sound smart, crumple them up and throw them out the window. If the person is having trouble breathing, give them oxygen. Sure, if they're just having some mild dyspnea and aren't gasping for breath, it would be in better medical judgement to use a nasal cannula rather than gassing them with an NRB at 15lpm, but asides from that, don't worry about it, give the old folk some oxygen and just LET IT GO! They can't remember lung sounds or signs of shock, but that hypoxic drive/COPD thing, that always sticks in the mind, doesn't it?

We're going down to Roanoke, Virginia, to induct 3 of our own into the EMS memorial from this year, Lt. Brendan Pearson and EMT's Timothy Keller and Felix Hernandez (the last two of whom died from pulmonary complications from working on the WTC post 9/11.) I'm going to start pressing and polishing my class A now.

Duct tape.

That depends. I mean, I've given cops and firefighter crash courses in EMS when I need an extra pair of hands on the way to the hospital, so having at least someone at the level of First Responder in the back isn't an idea I'm completely willing to discount, but then again, for a professional service, it's not exactly cost effective. First Responders are there to do just that, respond first, do what they can, and then let the big boys take over.

Not having used hypertonic solution solution, my question is what type of effects does it have on the kidneys, and would this be a reason not to use it? Usually anyone who is in acute pulmonary edema has associated kidney problems from a chronic condition, such as systemic hypertension. Just wondering, I'm to tired and lazy to look it up and figure it out myself.

I've read much of the bible, and I think Christianity, in its truest form, is a wonderful thing. Unfortunately there are a great number of narrowminded people who like to pervert the teachings of the bible for their own agendas, and those are the ones that prevent me from being behind Christianity 100%. I have my own set of beliefs that sometimes conflict with Christianity but most of the time, I've noticed, follow the tenets of Christianity fairly well, but I really wouldn't classify myself as a Christian. My major sticking point is the whole "must accept Jesus into your heart" thing. A great number of people have tried to convert me, and I don't hold it against them, it's just I was made with always too much doubt and question in my mind to accept something wholeheartedly without any sort of evidence. It's just the way I am, it's the way I was created, and I'm pretty sure God will forgive me for that at some point, because that same doubt, and questioning nature also makes me good at my job. But the other stuff I'm down with. Jesus basically went around saying "Be kind to others, don't be a jerk, make peace, etc. etc." I really like the parables in the New Testament, and reading about the trials and tribulations of Jesus during his work on Earth has brought me a little comfort during my dark periods when I wrestle with my own trials and tribulations doing my work. It gives me hope that the right path in life and the way to being a good person is always the hardest, rockiest, and most filled with peril and sacrifice. Unfortunately, like I said before, in the modern world the same teachings that were supposed to bring peace among people is currently used to make war and spread hate. Do you really think that if Jesus returned tommorrow, long hair and all, and started preaching peace and love and acceptance, he'd go over really well with the bible thumping war hawks in office? Makes you wonder who's side they're really on. Also Pat Robertson and Jerry Falwell are going to hell. And if they're not I don't wanna go to heaven.

Okay, as suspected, it was in the paper. Man buys ticket to 86th floor observation deck, gets off on the 66th floor, and jumps. 600 feet, straight down on to solid concrete. Wow. 34th person to do that since 1931, when the building opened.

Okay, so today I'm in the office grabbing my gear, and I hear the BLS asking about a "jumper down" call. Here we divide suicidal jumpers into two categories "jumper up", as in they look like they're going to, and a "jumper down", in which, well, they did. I leaned over my lieutenant's computer to see the call text, and I see its a confirmed jumper down, 34/5. The first number is the street, the second the avenue, so its 34th Street and 5th Avenue. I hadn't had my coffee and I was preoccupied with my radio so it took me a second before my mind grasped the ramifications of the address. I stopped and asked my lieutenant "34th and 5th... they don't mean the Empire State Building do they?" Indeed, I was correct. Yes, someone actually jumped off the Empire State Building today. I don't know what floor he jumped from. As everything that falls from it though, he apparently landed on the 6th floor set back. I wasn't on the call, but I'm pretty sure I didn't need to be anyway.