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I think the fact that providers are doing CPR for 40 minutes anywhere speaks volumes about the need for drastic changes in EMS. Not in terms of response, but seriously, after 40 minutes of CPR you really think there is going to be any chance of saving this guy? You're going to risk a helicopter evac for a cardiac arrest on a mountain top after 40 minutes of CPR? Okay, tell me, which is more likely, a helicopter crash killing all aboard, or a person being succesfully revived with good return of function after being in cardiac arrest for over an hour?

Given my salary, I'm getting darn close. The person below me has at least once wondered what sex in the back of an ambulance is like, and then thought about who it would be with

Third of all, and the post about all EDP's being cuffed really surprises me, being crazy isn't against the law. EDP's are mentally ill, they are sick. Yes, I like to have a nice police officer take the ride with me, in case Mr. Mentally Ill person decides to get rowdy, but really Rid, if a 16 year old girl breaks up with her boyfriend and in the midst of her angst she threatens suicide and her parents panic and call 911, they slap the cuffs on her and throw her in the back of a squad car? Wow, as if she didn't have problems before, huh?

Except that expert marksmen can tell when they've fired a blank because the barrel is cooler. It's a nice thought, though.

If you mean "The Bush administration's plan for victory in Iraq," then yeah, I read science fiction. Let's see here, the person below me doesn't appreciate sarcastic political based humor

Keeping our call volume up, mostly.

See, shootings omeone and using your knowledge of medicine to cause their demise is apples and oranges.

I took the oath of Geneva before I was sworn in. I think knowingly administering a lethal injection to someone would go against the principle of 'primum, non nocere', and therefore would not do it. Defending yourself against a patient is one thing. Pushing something you absolutely know 100% for sure will kill someone to a person strapped down to a gurney is another. Therefore, I would be unable to do it, and quite frankly, I wish they'd stop using paramedics to even start the IV in lethal injection settings.

The only person I ever gave grief to calling me an EMT was my sister, and that was mild. I really don't mind being called an EMT, after all, I am an EMT-P. Despite having the words "paramedic" in very large letters in several places on my uniform, I still get called "officer" more times than I can count. People who call you ambulance driver obviously don't get out much. Don't let them bother you. A good retort to nurses is to call them "candy strippers".

Sleep, a couple of beers, then consider doing my laundry. Yes, I'm single.

I used to have a '91 Celica until the alternator died and then it got hit by a street sweeper. Rest in peace. :-({|= I am now regulated to public transportation, unless I'm driving at work, then I'm behind the wheel of a heavily customized Ford F-350 XLT Powerstroke Turbo Diesel. They're built like tanks, with reinforced steel plating, diamond plate, and high security door locks....Step on the accelerator and WATCH OUT CABBIES!!! VROOOOOOMMMMM!!!!! HA HA HA HA!!!! Sorry, sorry, I got a little carried away. Our ambulances are sufficient for our emergency response needs. :oops:

I rarely read JEMS or Firehouse or any of the others, if only because I shy away from magazines that want to be taken seriously but always seem to have an explosion of some sort on the front cover. I actually get more out things like NEJM (swipe 'em from the doctors lounge) or even magazines like Popular Mechanics or Consumer Reports (product recall, particularly) give me more vital info for work than the so called "trade magazines". The explosions on JEMS do look nifty, though.

Extra Marital Sex I didn't come up with that one. Look, we drive around for long hours in something with a bed, lubricant, and restraints in the back. What do you think is gonna happen?

Unfortunately it was still at least two points up the literacy scale from some posts I've read that WEREN'T done for ironic emphasis.

yeah I wuz never much for that larnin' I just tell ya just throw 'em in the back and stay outta mah way that's all I dun need to know them pointy headed doctors they don't know what's what anyhow

All right, phireman, I'll clarify my terminology. When I say "profession", I mean "recognized by the general public as a job that one works at and gets paid for and makes a living at. Ask someone what they do for a living, they might say "carpenter", they may not have a degree in anything, but it is recognized as something that takes skill and dedication to do, and you can make a living doing it. Just put yourself in my shoes for just a minute. Imagine you've been scrimping and saving to go to college, hard cord science courses, application exams, application fees, hours upon hours of sitting and learning and testing, that has taken years, so you can stand proudly and say "I am a paramedic and I am proud of what I do", and then be lumped into the same category as Skippy the 19 year old whacker and Boseevus the unemployed trailer park dweller who can sit around listening for auto wrecks because he doesn't hold a job. It's not a good feeling. Respiratory therapists, paralegals, nurses in many areas, a variety of established jobs use people with associate's degrees. If some medics make you feel inferior about your knowledge, grow some thicker skin. Being a paramedic is a legitimate public safety profession, on par with, and of comparable training to, being a police officer or firefighter. We get killed in less spectacular ways, but just because we expect to get paid for it doesn't make us any less dedicated to our jobs or our patients than anybody else. Believe me, no paramedic gets into this line of work for the money. Ace, I think I was a little hypersensitive to your first comment about the box colors, but its because of the environment I operate in of hostility and ignorance towards Advanced Life Support. Because of the greater number of EMT's than medics in my union, BLS in all its warts and glory is heavily favored, while basically paramedics are regulated to having to beg, threaten, and cajole the BLS crews into letting them treat the patient, so I do get testy when I think someone is spreading false statements about exactly what we know and can do.

I have been an advocate of having a good basic working with me. But it's attitudes like yours that make paramedics look down on basics. As for Ace, sorry, I don't apologize. If you don't want to be accused of being an undereducated BLS provider, than don't write posts that make you sound like one. If a paramedic in your area has really been through a course in your area, and has passed the certifying examinations, and is ok'd to work by the medical control physician, and still cannot identify the drugs administered to the patients save for the pretty colors on the boxes, or does not recognize the importance of giving a detailed and accurate report to the recieving staff, then that is one very, very messed up system and I am surprised that a medic of your caliber who went to such a progressive medic school would risk his integrity and reputation by working in it. And while you might want to try to thumb your nose at my program, the BMCC accredited AAS program, you're not going to succeed. Our class graduated 9 out of 40 people. All 9 passed both the NYS paramedic exam and practicals on their first try, and all 9 passed their REMAC NYC certification as well, all 9 of which now work in the field as paramedics. We worked under the doctors of the New York-Presbyterian system, learned along side the medical students from Cornell University, and our CIC was former deputy chief of EMS for New York City. That's why I say that with out a doubt, ym program graduated some damn fine medics who were trained at one of the highest standards in the country.

Convince his wife to run off with another woman. Gets 'em everytime.

Pain isn't completely intangible. I would like to think if you are the point you need to give analgesia, the patient will be showing physical signs (moaning, screaming, rapid heartbeat, thrashing) to indicate how much pain they are in. If you have a someone with a midshaft femur fracture, screaming their head off, I think I can assume that's a '10' on the pain scale. I'm a big fan of the new push for better pain management. Suffering never helped anyone.

>"yeah we gave him 4 purple boxes, a yellow, and a green! He stayed in a pulseless type rhythmn, and never came back. >Unknown down time, and he's a diabetic, we were at his house ealier but he was fine and we got a refusal!!!" This story, and the fact you expect us to believe it, really shows that exactly what paramedics have to go through to become certified is still very much a mystery to most lower level providers. You do not have pharmacology, pathophysiology, and anatomy and physiology pounded into your head and still think of the medications by color codes. If this story is indeed true, the medic was being as asshole and flippant. This reminds me of the EMT-lieutenant who told me medics couldn't diagnose a "heart attack" without our machines. She must have meant the heart attack detector we carry. In regards to what Dust said, yes, in a busy system the amount of patients needing care sometimes makes for the need to give condensed patient care reports. Somewhere along the lines people who really want to work in busy systems thought the way condensed reports were given sounded "cool." These people are stupid. I've seen BLS providers flip out when they don't think medics are giving a report "properly". A proper verbal report is when you get the most critical information to the doctor and nurses in the shortest time possible. For example: Doctor: What's going on? Medic: Tight Asthmatic, used her pump three times today without relief, prior history of intubation in 1994, wheezing in all fields, EKG is normal but fast, gave her 3 treatments, point three of epi, started a line, also gave her 2 grams of mag and 12 of dex, she's opened up some but her sat still sucks. This is not the proper medical terminology, but the medic is not saying it to sound "cool", he is saying it to get the critical information out their quickly.

I still am waiting for the complaints about the a-hole BLS providers. LOOKIT ME! I GOT BRAND NEW SUNGLASSES FROM GALLS AND THEM MEDICS BETTER STAY OUTTA MAH WAY!

I think there are such things as paragods, but I think you're right in that they have probably been jerks all their lives, and just happen to be in that position, rather than vice versa. I think though, we need a non-obscene word for the BLS version. That is, an EMT who walks around like they know "the real deal", like to critique medics, and usually spend most of their time complaining about the "lack of BLS experience" of a paramedic, no matter how long they were an EMT. Let's see... EMTampon, no, ummmm Basic Life Slacker, nope...ummmm....well Randy Rescue was good, but that's more than something else.... We used to use "Medic hater" in TOP class, I dunno. Someone creative come up with something.

Dust, I'm not arguing against private ownership of guns. I'm trying to say there is a big difference between someone owning a gun in the privacy of their own home, and have someone going bursting in on other people's homes armed with a machine gun, his only qualification being he is an EMT. Can you see where I'm going with this? BTW, I don't have kids, but if I did, you'd better belive I would keep GWB et. al far far far far FAR away from them. I don't want to see them grow up driving drunk.