Mateo_1387

If divided up, each ambulance in our county (if all of them were centrally located) would be have 12,650 people in their area.

I wish you the best of luck FD5. Maybe the time away from each other is what you needed. I am probably blowing smoke, but whatever. Hope it all works out. Take care bro.

There, I fixed that for you I already tie people to the cot, cut off their clothes, and sometimes without their consent ! It is much more fun that way, cuz the person really does not want it. Some say its worse than Rape, some say its better.

What can RRT's do skill wise? So pretty much my list was accurate? I have met level IV RN's (this may just be a NC thing, I am not sure) who have an extensive scope of practice, and are usually the ones working on Helicopters or critical care transports. On the other hand I have definitely met some RN's, who just do ER nursing, who do a great job, but would not be suited to working in an ambulance. Of course, there are plenty of people already in EMS not suited for the job either. I always thought of EMS and Paramedics as a beast of their own. I know some training overlaps, but that should not mean every RN, MD, and PA should be able to be a paramedic by just passing a test. Just certain ones. I really have a problem with a Dentist working on my grandparents, or a Dermatologist working on my Father. Now a level IV Critical Care RN who has ICU experience and years of acute nursing experience, I would rather see them working on my family than a lot of career medics. I would like to see EMS one day get their own and be able to hold their own, the way other health care professions have. Thanks for the quick reply VentMedic.

That is an interesting thought, since Lasix is a potassium wasting diuretic. But we would also have to worry about all the protein breakdown from the crush, other toxins and other electrolytes.

Now that is surprising. A dentist can challenge the EMT-P exam. I am curious about the overlapping of education that exceeds and EMT-P Training that should allow them to challenge the paramedic exam. The only ones I could really think of would be certain MD's, Certain PA's, and certain RN's. I say certain meaning that they would be working with acutely ill patient such as an SICU, or maybe ED.

I sure do, it was a great one !

I know you said to PM you, but I think this information would be good for any and everyone to see. Especially for any new members who are also interested in EMS in NC. Some other people will probably give you some information on this site. There are a few of us who post that live in NC. Off hand, one EMS agency comes to mind that is Fire based (towards the east coast) which is Morehead City . Morehead City is very close to the beach. Here are some links to Morehead City EMS/Fire, also one of the sites give a list of different cities that have EMS/Fire http://www.townofmorehead.com/Fire%20&%20EMS.html http://www.moreheadfire.com/ This link is the link that shows all the EMS providers in Carteret County, which Morehead EMS/Fire is one of them. http://www.carteretcountygov.org/departmen...ncyservices.htm There are some really good agencies in NC that are not fire based. Wilmington NC is supposed to have a good EMS system, and they are located right on the beach. They are hospital based, and the first to be classified as a Model EMS system in NC. http://www.nhhn.org/body.cfm?id=31 Pitt County is close to the beach, and they have ECU (Go Pirates). JakeEMT may come and be able to give you the low down on Pitt Co. EMS. http://www.co.pitt.nc.us/depts/emergserv/ems/ Craven County is supposed to be a good system also, they are hospital based (some of it is) http://www.ncems.org/employment.htm#CRAVEN-RMC If you are looking for a more central location (about three hours from the beach) there is a really great EMS System, which is Wake County EMS. Raleigh is inside of Wake County, and they have what you may call Suburbs. Raleigh I think would really fit well with you. They are a large service. There is definitely room to move up in the department. They are working to provide a career ladder for EMS personnel. They have many different areas of EMS you can work (bike team, usar, tems, all that fun stuff) plus they are active in research and the like. The pay is decent, and the area is rated very well to live in. The only thing I do not think fits well with what you specified in your post is that they are not fire based, although they do work closely with the Fire Department, because fire goes on a large number of our calls. http://www.wakegov.com/ems/default.htm www.wakeems.com You can always check out the EMS job postings at this website http://www.ncems.org/employment.htm

And man, what a great story for the squeamish, while drinking beer and playing pool !

Dwayne ! Thats awesome Bro !! I wish you the best of luck while there. I am sure you will be awesome ! Stay Safe Matt. (On a side note) You're one to be talking, ya know...

How about an undiagnosed Tumor on the Pituitary Gland. I am just giving some guesses off the top of my head. Of course I guess it is also possible for his drug dealer to be giving him vasopressin instead of heroin. Not really.

And along with what AZCEP said, the low BUN level, this would account for his body trying to keep all the Na+ it can.

After looking up lab values, one that stuck out for me was the hyponatremia. Some of the effects of hyponatremia are brain swelling, which would account for the narrowing of the ventricles. Also hyponatremia can cause malice, nausea, convulsions, and coma.

Why is it a pet peeve of yours? To me it is their problem, their safety at risk. Your safety is not at risk, as you already have your protective equipment on.

Absurd. You can just tell should be proof enough. I guess if you wanted "proof," you could observe the medic for competence(not quite proof but so freggin close its not funny), then walk up and ask him or her if they are a degreed paramedic, or just a medic mill paramedic.

I thought I would be nice and go ahead and describe from your post how the current medic mill classes are. This is exactly the problem, too many people are trained, not educated. I guess we can keep dumbing it down for the least common denominator. I do think that a class in professional report writing should be mandatory. Why not both? It will make you a better person, and it will make you appreciate the art your patient have in their houses.

It is more than just time. It is very obvious that you are not a degreed paramedic, or if you are, you did it after the fact. All the classes in a Degree program help the paramedic. Even the english classes help. If you are in EMS, then you know how horrible EMS folk are at grammar and report writing. Classes like Psychology help you to have a better understanding of your patient, especially the psychiatric patient, which many EMS folk lack knowledge of. Anatomy and Physiology is the basis of what we do, I still have not figured out why that is not a requirement for ALL schools. Every class in a college ends up giving you an advantage. Consider a college education like a lever, it helps to make you a better person at whatever it is you are doing. You may not see it, but there is a wold of difference between a properly degreed paramedic, and a 9 month medic mill paramedic.

I think it is kind of funny myself. I might watch it just for kicks. I am not going to get bent out of shape over some guy that calls himself an EMT, and goes up for the "moment of truth" just to make himself look bad. We have a whole lot of other things that make us worse off than that one guy. It ought to be funny if he has done it. I mean, everyone knows what they want to hear, and he will probably say it, just for the attention.

They work on Nicotinic receptor sites.

I agree with Jake that the Helicopter is an overused resource. One thing the two counties I work for can say about their EMS systems is they will not call for a Helicopter unless it is absolutely needed. When I was going through orientation, they told us that they had a call once on the far side of the county where a man crossed the county line in his personal vehicle and had severe burns. Well the burn center is in the next county over, opposite to the side the call was on. Transporting on ground would be about a 60 mile run. Well the crew called a helicopter to take the patient to the burn center. Well being that the county does not use a Helicopter unless absolutely needed, the medical director did some searching, and found out that that ground unit could have transported the patient and arrived at the burn center long before the Helicopter arrived with the patient. It just went to show us that even our longest transports have no reason to utilize a Helicopter (and if so very very very very very rare).

Thanks for the reply, that answers my question. I am picking your brain a little bit here. Why would you want to use amiodarone instead of the cardizem for a-fib with pulmonary edema? This question is for anyone really.

Yes we do want to hear it. How did you get away with it? Any advice?

He has an arterial clot in his leg, how would that go to his lungs or brain? I would think that he lucked out that it did not go to his brain.

I never really categorized them like that, but I guess it works. The anticonvulsants you mention, Klonopin and Phenobarbital, I do not think is accurate in that they work at the site of the muscle. Klonopin is a benzodiazepine, and Phenobarbital works in the brain, not directly on the muscles. They both act on Gama Aminobutyric Acid (GABA). A drug that would work directly on the muscles would be paralytics such as Vecuronium, or Succinylcholine. Tegretol works primarily on calcium channels, but does affect sodium channels, GABA receptors, adenosine receptors, and increases serotonin and other neurotransmitters. Dilantin on the other hand works primarily on sodium channels. Benzodiazepines are primarily known to work on GABA, though Valium can be used for muscle relaxation. Benzodiazepines are used to treat seizures as they occur because the quickly increase the effects of GABA.

Why would Pulmonary Edema be a contraindication for Cardizem, especially considering some pulmonary edema is linked to afib? Not that it would always be my first treatment for pulmonary edema, but why would it be contraindicated?