Mateo_1387

So what are your findings of the EMS system's response to your college campus? Forsyth County EMS is one of the more highly regarded one's in NC. You sure there is no reinvention of the wheel? With the system and local hospital, its a good place to get hurt. Besides, how often are there injuries necessitating EMS services? Not trying to bust your bubble, as you seem to be intelligent, trying to write proper proposals with financial constraints and statistical analysis included, but, I get the impression that you are looking for an outlet to play EMT, so those skillz won't depreciate and become stale. With such an obvious intelligence about yourself, as well as your interest in EMS, are you sure set lighting is your calling?

Bieber, I must say, it is a pleasure watching your progression as a paramedic. Almost like reading my story… In regards to the topic though, you pose an interesting question… (I’m just going to ignore all the parts of you stopping at a crash scene for something other than distressed models involved in a fender-bender on the Playboy Bus and focus on the part about scene presence) This may sound cliché, but being in charge is not about acting the part, so much as knowing you are in charge. In a way, it is about having the right mindset to guide your actions and not just being able to bark the loudest. Being young, you will have to get used to the fact that other responders, patients, and their families will commonly address the older looking crewmember. The same kinds of things happen to other providers who happen to be ugly, non-white skinned, are rude, have physical defects, or whatever. Just one of those things man… Being confrontational with others on a scene, unless it is necessary, is ill advised. Confrontation will mostly create uneasiness between the different providers and the patient’s perception of said providers rendering care to them. Plus, honestly man, being confrontational, rude, or the like is just what all the old heads are going to expect from you. Please do not play into that trap. Honestly, I find the best ways to have scene control is to do a few simple things: Be calm, cool, and collected. Speaking up a little always seems to help, but not so loud people don’t want to hear your voice. During a ‘bad call’ giving directions to others helps establish your control. On the not so bad calls, how you explain things or ask questions can help establish your scene control. For example, saying to a patient “is it ok for my coworker Amy to take your blood pressure?” Indirectly, it lets others know what they are to do and it is a nicer way to take scene control. I think you will find on most ‘bad calls’ taking scene control is quite easy. Most people are scared on the bad calls to begin with. Being calm and guiding others’ actions usually does the trick, as most people don’t want to be the one in charge of a bad call. Your scene presence will develop over time along with feeling comfortable in the new paramedic skin. Being in charge can be quite an eye opener, especially when you may be responsible for leading folks with more age/life experience than yourself. Definitely learn from what anyone with that experience has to teach but work on being the adult you’re expected to be and not so much the kid you were trained to be for the past majority of your life.

1.) To answer your first question, I dunno. I still go bat shit, just from the phone ringing ! Seriously though, I do not know when one starts to feel comfortable. I seem to get quite comfortable, then out of nowhere, something comes along to shake me up, then it seems things are back to square one. My perception though, is the ones that are comfortable with all calls are the most desensitized, and I'm not quite sure I want to ever reach that point... 2.) LOL. I love it when people ask this question. Everyone seems to have a wild, rare, you see once in a great while type of call as their first call ever on the ambulance. Anyways, my first was an open femur fracture due to a vehicle wreck....

Have to say this is certainly not the best message to share when you want government working together and not putting their differences and views about 'other people' out there to cloud the political arena. What his message said to me though is that he separates himself from the general population in a egocentric way. This of course is not something I would like to see in a leader of my country. With the different cultures and value/moral systems that make up the US, I would rather see someone in office who thinks we are basically the same because we all have a belly button than to have a separatist mentality because of their religious chip placed on their shoulder.

Man, I think anyone could use the resources of professionals, weather they are pathologic or not. Just being able to explore our minds with the guidance of a professional that can be trusted is not a bad thing. The same also holds true to talking about what is going on in our minds with our friends, family, and community. To PCP, I have entered this discussion a little late, but how are you holding up? It is not uncommon to be stressed by calls where the adrenaline is running rampant. This was a new experience for you, so questioning the experience is not a bad thing. On a personal level, professional level, and even as a society, a lot of weight is placed on running this call just right. The truth of the matter is that the call can always be better, but I do not think it can be perfect. Also, I can completely understand questioning the call since you have not seen it done in the past. There is nothing really for you to go on about how the call went compared to another cardiac arrest. But now you have that experience. Use it to make the next one go even better. I do not find myself plagued by mental images of calls weeks after they happen. I do take some time after all calls to review what could have made it run smoother and then I let it go. At the same time though, I would never want to memories to disappear. The emotions that surround such events make us who we are. For example, you remembering the wife performing CPR on her husband, realizing the emotional impact that such an event would have on the wife, really shows how in tune you are to not only the medical needs of the patient, but the mental needs of the family. Us remembering is the drive that makes us strive to be better. They key to situation though is acceptance. Once you are able to accept the whole situation, the good and bad notwithstanding, only then does it become easier, IMO. As many times as you have replayed the call in your head, I have no doubts you have identified things that should have gone better. Just realize that what happened is done with. Now you get to focus on the now and the future to make sure it goes even better. And it will, with your new experience to help guide you. Also, make sure you identify the things that rocked during the call too, those are just as important. Thanks for feeling comfortable enough to share your experience with us, I for one always learn from these discussions. Matty

Mazrin, to start off with, great first post ! Stick around the City, you should find it invaluable during your tenure in EMS. Although there are some great posts on this thread, I would like to give you a perspective from more of a mental standpoint coming from a young age. I am a 23 year old Paramedic. I am in eastern NC, and my EMS experience is limited to this area. With that in mind, anything said following this is not necessarily how things are on the national level. As a young person entering the EMS field, it can be quite a challenge. Being this young, we still have a lot in life to figure out. I have noticed (personal experience) that between the ages of 18 and 23, we are learning how to be "our own person". The mentality changes from being a follower (do what your teacher says, do what your parents say, etc...) to being an independent young adult really leaves us with quite different advantages and disadvantages. We learn to maintain discipline to do what is good and right, in light of not having consequences placed by authority figures (such as parents/teachers). We are still developing the skills necessary to stand up for ourselves as to not be taken advantage of by others. We are learning to better interact as an adult with other adults who can outrank us greatly with life experience. EMS can have a great impact on the young adult’s development. With that being said, the negativity in EMS, without having that life experience, can be overwhelming and bring out characteristics that you may not be proud of. It is important for you to be open minded with your new experiences, as you need to be able to decipher the good from the bad, and to think independently, and not follow the closed minded views you are certain to face. Without being touchy-feely, but rather quite honest, EMS experiences can create quite a roller coaster ride in your life. For me, I have reflected and noticed many changes that I contribute to my EMS experience. It really forced me to be a more confident person (although that is still changing to this day for me). Others typically will look down towards a fresh and young looking face, chalking us up to being hormonal and inexperienced, not really belonging in a high stress medical career. It taught me that I had to improve my confidence skills, which has been a positive impact on me being "my own person". The confidence shows others that you are ready to embark on the EMS journey. At the same time, it is important to be humble and realize that there is still a lot more for us to learn. As others have mentioned, separating work and personal life has also been another lesson. Although not limited to the young adults, I think for young adults, it where the skill is best learned. It was quite easy for me to succumb to bringing my stress from work to home. Starting out with good habits and practices can define how your whole EMS experience is. Although you are still in the learning phase, remember to learn what is right. The best learning you can do is to question and find out for yourself, not relying on Joe Blow’s opinion. On a financial level, many people find EMS to be inadequate. Being young and unmarried, it is more money than I probably need. It is nice to see a paycheck and know that I have plenty of money to do pretty much what I like to do. Now applying that to a family would be different. While I believe it is doable, with an EMS salary, to support a family, more money is always better, right? Many families live off of less money than an EMT makes, so, it should be doable. Will it be easy, though, probably not. When I get married and have three kids popped out, I’ll come back and let you know how it worked out. I like my job though. I enjoy the nature of the work, the environment, challenges, and learning aspects of the job. That isn’t to say that it is the mother lode of all jobs. I am quite sure there are other jobs out there where I could be just as happy, if not happier, and better off. Why do I stay you ask? Well, probably complacency. But, it is not uncommon to stay where one feels safe and secure. Changes can be scary and that probably has a bit to do why people feel stuck in the profession. As far as careers to transition into, most feel that EMS should not be a transition career, although most think it is. I say transition into whatever you will be happiest with. A lot of folks transition into nursing, some move on to PA and the like. Others though, remain in the profession. There are also opportunities to work in a hospital or clinic setting as a paramedic, so there are some options for you. At our age, there is so much to do, I wouldn’t recommend making up your mind, but rather being flexible. Realize that in a year from now, your thinking and mindset will be different, and as such, your decisions for changes need to be made accordingly. My successes are not based on buying a house or raising a family working EMS. Rather I consider the success to be personal in nature, in that I am happy with the decisions and directions my life has endured. I think that is the key reason you find such negativity in EMS. Many people are unable to be a generally happy person. I am sure you are familiar with the saying ‘misery loves company’. Make any sense? Good luck Marzin, I hope this helps. If you wish anymore information from the ‘kids’ perspective, just ask ! Matt.

First question you should answer, just so you will learn, and have more knowledge than before is 'what is the difference between a pneumothorax and a tension pneumothorax? I like that you think about other possible injuries present with an injury such as a flail chest. Besides damage to the heart, what other injuries could you suspect? A couple of points to bring up... concerning the posts where I have made certain lines stand out in bold. First, concerning treatment with sandbags and IV bags, it is now considered to be outdated treatment. IV bags and sand bags (weight) placed on the chest can hinder the effort of breathing. Mobey brought up a treatment that is useable, a pillow or towel for the patient to use to splint their fractures themselves. I had not heard of this, but think it sounds like a good idea ! So, I will ask, since sandbags/IV bags are considered outdated now, what other splinting technique is recommended? When you find this technique, what would be an improper way to apply the splint, and why? (to give you a hint as to the improper application of the recommended splint, think of how its application would possibly hinder the effort of breathing) In reference to pressure x3 and sandbags....see the above response. It has been surmised that in trauma, we can predict the underlying injuries based on the mechanism of injury. With that in mind, mechanism + the area of the rib cage injured can give us great clues as to what injuries are present, before hemodynamic changes may be seen. What other short term injuries may be suspected if the patient was struck in the rib cage? (think about what the ribs are attached to) Pneumonia may very well be a complication that flail chest segment patient may have to endure. To help you think of some other 'pulmonary problems' the patient may experience, what complications will commonly present in the hospital/ICU? (it is possible to see these in the field too, but not common, in my experience) I think another aspect for people to explore is signs/symptoms, and assessment findings you would expect to see, feel, or hear?

Welcome to the City ! Although age may disqualify you from working for a fire department, I say piss on them. I think your age/life experience would be a great asset to you being a paramedic, along with your customer service experience (as a lot of what we do is public interaction). Market yourself well stick around the City, you can learn a lot, and we will do our best to steer you in the right direction. Matt

Awesomeness ! Well worth trip for anyone interested. As BEorP said, the experience is great. The food is good and doczilla does not resemble godzilla in any way..... Ha, did I fool anyone?

Spenac, time for you to go back to the basics... It'd be a good idea for basics to sit a patient up that has a high blood pressure, and lay a patient down for low blood pressure. There, that was simple. -5 for a stupid question. If you don't know how a cat scan can change the treatment, then go get a book. -1, for simple ignorance. Spenac, this could be such a great topic, but, being such a poser, you sure can run it into the ground. The sad thing is, I agree with a lot of what you say, but you're merely an echo, IMO. You have also echoed yourself, multiple times. Please, let me reference everyone to these posts, by none other than Spenac. This fetish of your's about exposing patients is really starting to be an old tune... You first posted about this subject on 06 May 2007 Here is a link. On 21 Jan 2008, you brought up the subject again. Reading through, its not a bad thread at all. Its title is "Did You Look And Feel? Hands and eyes on?". But, after your last post on 7 April 2008, why, I guess you just love talking about exposure so much, you bumped it on 22 Oct 2008. If you would like the link, Click Here. Oh, I almost forgot ! -5 for not using the search feature and duplicating a topic. But that just was not enough. On 17 March 2009, you just had to revisit the topic. And by the way, I just loooove the name of this thread "Proper Exam Technique - Expose or Fail". So, you apologized earlier for what seems to others to be an attacking delivery message. With a topic title like Expose or Fail, what makes you think we'd take it as attacking... Anyways, I'm sure everyone would like to see a link. Click Here -10 for not using the search feature and duplicating a topic, twice now. Also, another -5 for being hypocritical towards others about using the search function. Then there is the current thread. Here. The 4th time now that you have discussed it. Except now, as I have observed over the years, you have become much more pompous about your position. So, I guess -20 for a triplicate post and not using the search function, another -10 for being a hypocrite again, and another -5 for not using spell check, and other -5 for just being egotistical about this topic. Folks, honestly, this is a good topic to discuss, if you read some of the older topics, you'll see some posters from back in the day with some good things to say. Again, all Spenac is doing is echoing others, and then himself. I just hope people can see it for what it is.

Good ol’ classic Spenac post, pose a question that seems to ask for opinion, yet he already knows what the correct answer is (at least by his viewpoint). If you’re answer agrees even halfway with his, then you are still completely wrong… and furthermore are deemed scared, unprofessional, bashful, and therefore must obviously be incapable of saying penis and vagina without giggling, so you must surely call them private parts and no no’s… I digress… So, what was the point of this post Spenac? Did you’re post from the past covering this topic get deleted or something? Felt enough time went by that you could duplicate it without many noticing? I take it you also expose and palpate the vagina and anus of all the rape victims you encounter? How do they feel about your ‘professional exam’? I guess you do the same for the child victims too? Do you also prefer to do prostate exams on all males over 40? I bet that one goes over real well...

I thought it was pretty funny !

I have used it once, in two years now as a paramedic. We use it for seizures and sedation.

emtbasic13, I do not wish to do IFT on a full time basis. When I was first certified as an EMT-basic, I worked for 3 months at an IFT service. I did not care for it too much. My current service has two divisions, EMS and IFT. I have worked a couple overtime days on the IFT side, and actually found I enjoyed it, as it was a break from the normal. The things I especially enjoyed about it were being able to meet people that were not worked up because of a medical emergency. It does not require serious and prompt action, except in very rare circumstances. Talking to patients and their family (if a family member rides along) was always nice. Especially if you have regular patients, they can be fun to keep up with. It is always nice when you make an impression on persons and they request you to come pick them up again. I hope you work with fun people, as that makes a difference in how the day goes. It is not uncommon to pick people up back to back, multiple times. Depending on how busy your service is, you may or may not get scheduled breaks, or just plain down time where you just do not get calls. Another enjoyable thing is going on out of town trips, its nice sometimes to just go to a new area and see things. I find with dealing with the local nursing homes that if you smile, be courteous, be understanding when the nurse just can't get to you at that red hot second, that you get much more out of them in the long run. I do that on the 911 side, and after a few months, the nurses got to know me really well, knew I was not going to be an asshole to them, and would bend over backwards to help me (moving the patient, reading off their history while I am preparing the patient for transport, etc...) Make your patient's comfortable, thats just common courtesy. If you follow those things, along with getting through your 'learning the job' phase, things should go well for you. If you are not looking for emergency calls, then you can enjoy this job quite well. I find those that just want to answer emergencies cannot handle the IFT business for lengthy periods of time. Good luck to you. Matt

I don't find it too funny, but maybe it was one of those things where you had to be there to appreciate the humor. I would feel worse for the parents reactions towards the situation than I would the kid's reaction. The parents can understand 'I'm sorry, but we lost your son' as meaning the kid has died. On the other hand, I don't really think the kid would understand it the same way. I think the kid would understand 'lost' literally, meaning they could not find him, which makes more sense. Plus, what kid really knows how to fake being unresponsive. If the kid is fighting because he is afraid, how does he rationally think 'Oh, let me play dead' to get out of this shot? I find it hard to believe the kid used rational thinking during a fight/flight response...

I was in the 9th grade at the time, Algebra 1 class to be exact. My teacher, a very crass person, made a comment about the attacks that 'y'all do not need to worry about it, we're doing math, its not like they are gonna hit our mall'. I do not think she realized the severity of the attacks, but neither did I at the time. I went to my next class, band, and we just sat around watching the TV keeping up with what had happened. It honestly took me years to really appreciate the tragedy of the situation. I do remember days and weeks following 9/11 the amount of people who were making the tear-jerker songs, and those writing on their back windows about being patriotic. My initial thoughts were few. I had no clue what the trade towers were, I did not know how tall they were, nor how many were killed. Again, it was years before I truly understood the situation.

Hypotension Tachycardia 10/10 chest pains, what I assume are radiating to the back, abdomen and flank Significant nausea, with vomiting The shock state and significant nausea are plenty reason to check the right ventricle for indications of right coronary artery occlusion. The crew may have performed at standard 12 lead first, found ST elevations in the inferior leads, and then done the right side check for the right ventricle involvement.

I am looking for a little information on Wake County EMS from the employee prespective. 1. What can a first year paramedic expect to make their first year? Not sure, they may have this posted on job ads if there are any out there currently 2. Is overtime avaliable? There is plenty of overtime to occupy your time 3. What are the benefits like? You should be able to find this information on the county website www.wakegov.com 4. How is the retirement? Again, check out www.wakegov.com Their benefits are the same for all employees, to my knowledge. 5. What is the call volume like? I want to say it is close to 80,000 calls a year. Of course they are a county system, so you can get rural assignments as well as inner city assignments, all bringing a slew of different experiences. 6. Are you assigned to a base or do you rotate? They used to rotate base stations every 3 months, not sure how they rotate anymore. 7. Is the turnover high? I am not sure what their turnover is. I do know they that have a lot of great employees that stay for many many years, as well as many that retire with the system. 8. How is the equipment? They have good equipment. They have new trucks all the time, after so many years and so many miles. Their medical equipment is fairly normal though.

I thought this was an interesting question you posed that required some thinking on for a little while. But then it dawned on me, it is really a pointless question. Just because Saudi Arabia wouldn't allow us build a cultural center at their Mecca doesn't mean that we have to follow suit on our own soil. We (supposedly) run this country on our own morals and values, not theirs. If we are supposed to be tolerant to the practice of religion, then that tolerance should be distributed equally to all, throughout the country.

I am not surprised. Aw hell, I went back to reread the article...I was wrong, I misread. I have a problem with giving benefit of the doubt in cases like this. The sad truth is that even though the truth comes out in the end, weather the guy is guilty or innocent, his reputation is completely ruined. Bushy gave us an example. Not only do these incidents make patients afraid of riding on the ambulance, it makes ambulance crews, especially crews consisting of two males, weary of transporting female patients, in fear of false accusations. I do agree that he does not help his case by running.

Six pictures of her in a bathing suit... that she doesn't know how they got there. I call bullshit on that one. If someone sent them, she had to have saved them, more likely though, she had someone take the picture of her on her own cell phone. I think it very well could have happened that she was touched inappropriately, but I get the feeling the patient is a bit of a liar too. Either way, the attendant is screwed.

I've heard good things, cannot recall anything negative. Are you on campus or working online?

Mick, you seem like a quality person. I am not familiar with the Miami area, but I would imagine you could find a job, even with the tattoos. Most places will probably ask you to cover them up, and, if you are willing to do so, then I think you will find that things work out well for you. Mobey makes a good point that visible tattoos are accepted more today than past years. As such, tattoos should not hold you back, much. If you find that you are not required to cover up the tattoos, then remember, your demeanor, compassion, and show of respect will comfort your patients more than you scare them with tattoos. I have yet to hear of anyone complain about a tattoo being the reason they received poor service. People bitch about demeanor, disrespect, piss poor attitudes, and the like. Granted, you will probably be judged for your tattoos, but once people see the real qualities about you, the tattoos will mean less. Croaker, I follow your thinking, so please do not take this as an attack towards you. I completely understand that if one's goal is to be accepted, then certain things may help or hinder reaching that goal, reasons being right or wrong notwithstanding. With that being said... Tattoos along with respect, compassion, confidence, and demeanor are a much better combination to make patient's feel at ease than a combination of no visible tattoos along with showing no respect, no compassion, lack of confidence, and poor demeanor. Its the folks that constantly interrupt patients, tell patients they are wrong, speak rudely to patients and family, tell patient's what they will and will not do, and the like that makes patient's feel uncomfortable, and scared. Hell, I'm a young looking guy, and I have seen patients that take a double look at me. I always figure they are thinking 'Oh lord please help me, this young guy will not know what he is doing'. I cannot change that I am young looking, but what I can change is how they perceive me when I open my mouth and by how I treat them. I don't think its the fact that I'm young, or the fact that you may have tattoos which causes poor patient rapport and medical care, but rather how we handle ourselves on the scene. Matt

Well, since you mentioned it... NC state protocols allow for the use of Nitrous Oxide. The only system I am familiar with using Nitrous Oxide is Medic, from Mecklenburg County. JakeEMTP may know of others...

What in the world are you trying to say?