JPINFV

That be the series of commercials.

] Maybe she swings for both teams?

Wow, someone can't take a joke. You can take stuff this seriously when some craptastic TV channel makes a show "about" your area, but fails at basic grammar by putting a "The" in front of the initials [screw you Fox]. You got beef?

When your scope of practice for a medical patient can be summed up in sugar, air, and kingsford in most places and one of the biggest mantras in training is, "You don't diagnose," then there is a problem. Unfortunately, the 120 hours does not mean that most basic providers know how their kingsford, air, sugar affects the body, so the end up giving things not because the patient needs it, but because "protocol tells me too." I don't believe it would take much to make basics competent in knowing what they are currently doing. Unfortunately, that scope, and therefore the affect on the patient, will still be limited in comparison to any other level of EMS.

As an interesting side note to the first aid kit, I have a trauma fanny pack. Don't laugh, it's required at the water pack with stocked with at least a thing of 4/4's, gloves, and a CPR mask. All of the life guards and EMTs [1 EMT on duty when ever the park is open] is required to have one. The EMTs just get a room full of goodies to stock ours with.

Did I ever say anything about degreed programs? Education can occur in a normal program. Education can occur while sitting in front of a computer or a book. That still doesn't mean that passing the class or getting a certificate (especially EMT- is something to be proud of when there are a lot of less then desirable providers out there. Remember, that certificate says that you [you not being directed at Whit] are equilivant to the worst provider out there of that level. Especially in the case of EMT-basics, that can be a very low bar. For the record, I'm a licensed "Ambulance Attendent." Does this make me better then my non-licensed brethern? Nope. Licenses or certificates do not determin how good of a provider you are, only a generalized usefulness (i.e. SOP).

The major things have to be top down. Take education, for example. Until there is a tangible difference in pay and scope between degreed and non-degreed providers, there is nothing to push people to become degreed. Now lets say you require a degree. First, do you have enough degreed programs in your area to supply you with medics? Are you going to be able to develop a bridge program for your non-degreed medics? Are you going to have a bridge program for people with other degrees (example would be an entry to nursing MSN program that several universities have)? Who ever makes this first jump will need to prime the degree pump and drag the old time medics kicking and screaming into the 21st century.

Why would anyone want to retire to Newport? Balboa is such a nicer area. /lives near the other Newport //yes, Balboa is still, technically, Newport...

I have an AM/FM radio and a cell phone (cell phone=my primary phone). If my work needs me, they can call. If it is a disaster, I'll find out on my AM/FM radio [assuming I'm not using the CD player]. For responding to my station, I have two forward white lights with a high and low setting. I have 4 amber lights, one on each corner of my vehicle. The amber lights can either be activated all 4 at once or one side at a time. I have 3 red rear facing red lights (again, dual settings, but seperate control mechanism then the forward facing lights). I will admit that my car has a forward facing auditory alert system. It is activated by pressure and should only be used to emit a short blast. The one finger salute is a valid, if rude, alternative to its use. I carry a personal first aid kit and an ambulance bag that has my steth, BP cuff, DVD player, and an assortment of movies (bag=standard backpack=in car for storage between shifts)

I actually do have a home made "mandatory reporter" kit (form, instructions, preaddressed stamped envelope). I just haven't gotten a chance to use it since I set it up.

And no, Paramedics cant open a trauma center, but they can be activist to the media and legislature to get more opened. We cant do it alone, but our voice can be used. The few things I listed are just sample suggestions. You bring up many "bigger issues" that need to be addressed, and you are right, they should be. My question is why arent they ? We all know what the problems are in EMS, but ask who is doing anything about it, and the answer is usually no one. But one thing that I have discovered is, that half of the battle is just deciding to tackle the problem, instead of ignoring it. We tend to say, it cant be done, and then we move on. But I am glad you brought it up, instead of just talking about it, why dont we see if we can actually solve one of those "bigger issues" that you mentioned. JPINV (or anyone else that is up for a challenge), If you could fix one of those big issues, which one would you choose ? Please post it, and lets put all of our brains together to solve it.

Don't forget about El Emigrante, the emmigrant game...

Maybe evolution is just God's pencil and eraser. He wants to change something, so he just adds a little here, removes a little there, and life goes on.

You can't force people to act. AED's are becoming abundent, for the most part, where I live. Unless you think we need to require AEDs to be placed with every fire extinguisher. I'd rather see my tax dollars, though, going to improving education, pay, and equiptment then fullfilling a pipedream that will go underutilized. Equating this to proactive fire protection has two problems. Problem 1. Early CPR, early defib, early ACLS, etc means nothing without early detection. Unlike a fire, which under most cases tends to announce its presence, cardiac arrests can be hidden. Having an AED in every building isn't going to save the person who has a cardiac arrest while working alone, while in the john, or while sleeping at home. Problem number two. You can prevent fires, but everyone will die eventually. You can train all you want, but the hospitals have two big advantages over EMS. Hospitals have controlled settings [doing dangerous [dangerous to the patient] procedures in less then ideal conditions in an argument for not doing something vs more training. You might only have one shot. Make that shot with everything in your favor that you can]. Again, what good is H&H if you can't do anything about it. Unless you're going to stop at the local hospital for a unit or two of blood [read EMTALA problems, protocol reworking, etc]. Cardiac enzymes are again useless prehospital unless you can do something about it. Why should a system that doesn't even allow its medics to read a 12 lead [they have to go off of the machine interpretation in my county] allow their paramedics to advance to a higher level? If your area has the ability to make prehospital lab values usefull, then go for it. I have a feeling that a lot of other areas have bigger dragons to slay [education, pay, better working hours/conditions, etc] then increasing their paramedic's SOP. So we go from computer based charting to something completely different now. Are computers helpful? Sure. Are there other things that need to be improved first? Yes. There is a big difference between equipting every unit with a palm pilot [which would have your Rx reference, etc on it] and buying every unit a tablet PC and networking them together. Because paramedics can just up and start a new trauma center or ambulance company anytime they want to, while making enough money to cover expenses. Can we at least stay in the realm of plausable for the average person?

Realize that dead is dead. You aren't going to be able to save everyone, and that cardiac arrest with no CPR prior to arrival is essentially dead. PAD's is more of a public health then EMS issue. RSI isn't appropraite for all communities. See all the research presented in other threads that shows that a good number of medics shouldn't be making people apneic to place a tube. Does it matter what the lab values are if the provider has neither the education or means to do anything about it? Passive hypotension, no more MAST/PASG , etc shows that critical traumas turn EMS into a fast cabulance. Untill, at the very least, ambulances are stocked with either blood or a blood substitute, this isn't going to change. It doesn't matter how high your education or how good your skills are if you can't stop any internal bleeding and the patients H&H bottoms out. What benifit does computer based reporting have for patient care, if any? It might make QA easier, but people are still going to have to read it.

I bet this thread is going to turn out exactly the same as a thread on another forum I read. So, for my prediction. In the year 2000, all the atheists gather around and try to convert all of the religious to atheism., while failing to see the pure hypocrisy in their actions. The faithful on the board will stare blankly at the atheists and respond, "I could care less what you believe." /unavailable for comment

What a waste of a perfectly good wheelchair van. That's what cabs are for. Although she might be eligable for an upgrade to a waabulance, if the baby survives. 8) :twisted: :blob6: :blob7: :blob5: :blob4:

While I have no experience with small towns, I wouldn't think that maintaining 3 veichles would be a bad thing. True, if they have enough money to buy a brand new unit, then they should have enough to pay. That said, the operational difference between 2 ambulances and three (again, MCIs, breakdowns, etc) and 34 vs 35 is large. If you have a large number of units, then loosing a unit isn't going to be too big of a problem. If you have 3 units, then you've just lost 1/3rd of your fleet. If that third veichle is on it's last legs (the age or condition was never mentioned), then you are setting yourself up for a world of hurt.

Ahh, but he seems to be calling the idea "retarded."

What if you do get 3 calls? What about MCIs? What would happen if one of the other two ambulances breakdown? I'd rather have too many ambulances then not enough ambulances.

Working part time for the past year, I've had 2 patients that I would have placed NPAs on. That is, of course, if NPAs were apart of the local scope of practice. [hint hint. Orange County, California is not a good county to work in as a basic or a paramedic].

[hijack attempt][sarcasm]Change isn't always good. First voting, then driving, then moving out of the kitchen. What will be screwed up next? [/sarcasm][/hijack attempt][ducks from the bricks being thrown in my direction]

Well, you are calling basics "professionals". Being proud that you have a "certificate" equates to being a moron, regardless of your level. Providers should be proud of their education, if they have one. The letters behind your name might allow you to do something, but the path to your current location determins how good of a provider you are. Protocols and SOPs are made for the worst provider, not the best. There is a women at my work who takes care of the stock room. There is a reason she isn't working on an ambulance. There is a similar reason why she has her NREMT-B certificate framed and hung in the stock room.

Fixed for clarity

Of course by "expanded" it means administering preprescribed Rx's that are, for the most part, already apart of the standard EMT scope (epi pen, nitro, etc) and dealing with different IFT stuff (saline locks, PVADs, foleys, etc) in an IFT situation (not inserting, etc).