JPINFV

The problem is that then you have the exact opposite. Places where all of the standing orders can be fit on a single page or two with mandated online medical control for everything pasted a stubbed toe.

In large parts of the country, that answer is a resounding "No!"

http://wbztv.com/local/ambulance.crash.brockton.2.1442158.html

From what I've seen about this, I think it's a little too much to completely blame the death on the two bozos. However, if you're in uniform, have any type of medical training, and are summoned to the scene by witnesses like that, you own the scene until additional resources arrive. That includes making sure that additional resources are requested. There's an ethical responsibility here that surpasses any legal requirement or civil liability of the actions that these two took.

I'm sorry... I thought this entire thread was about giving the EMT-B exam in a language other than English. Oh, wait. It is. Gasp. Who's talking about pestering people who has a functional grasp of English to the point that they can communicate and pass the EMT-B exam? I'm not as all of my posts were about a binary "able to use English" and "not able to use English" differentiation. This differentiation is completely separate than 'speaks languages other than English' and 'doesn't speak language other than English.' Hmm. Yes... because the ability to speak any specific language has to do with skin color or sexual orientation. So, which skin color does the 'dark skin peoples' speak? What language does 'the gays' speak again? Remember, you where the one who brought sexual orientation and skin color into this. You might not know this, but there really are other languages that are spoken in countries that are predominantly white and my opinion that people should be able to have a functional use of the English language when working in a direct patient role in the USA applies to those people as well. If I was as racist as you want to make me out to be for disagreeing with you, then I should be making an exception for Russians and French who don't speak English. Unfortunately for your character assassination attempt, I'm not. I guess I'm racist against white people then. As far as speaking or not speaking a specific language does not make someone an idiot. Incompetent for a specific job? Yes, and I hold myself to that standard. Since I don't speak Spanish, I am incompetent (as in failing to have competence. As in not able to preform the job properly. I'm incompetent in a lot of things. Flying an airplane is one of them. Strangely, I'm also ignorant when it comes to flying an airplane as a pilot) when it comes to providing direct patient care as a job (to contrast this with medical missions) in countries that don't speak English because I can't properly communicate with other health care providers, unless I want to hire an interpreter to follow me around. It would be imprudent, for example, for me to move to Russia and open up a private practice unless I learn to speak Russian.

So... in other words, you have no evidence that I'm a racist, classist, homophobic bigot then? I mean, just checking because if I continue to disagree with you while you keep changing the subject (bilingual vs not bilingual), I want to make sure that you can back up the mud slinging that you seem hellbent on engaging in like it's grade school or something. So, where is my homophobic remarks that shows that I view real only heterosexuals as 'real Americans?' Same question with middle class. Same question with republicans. Same question with skin color. Oh, and missions and employment is two completely different issues.

I never said bilingual wasn't important. However this thread isn't about bilingual providers. To be bilingual, you have to speak 2 languages and, per the original poster, the people he is directly concerned about at his company is providers who do not speak English. While English isn't a criteria to be bilingual by definition, for the intent of this thread the assumption being made is that one of the two languages is English. Do you not see where there's a potential for problems when someone doesn't speak the same language as the rest of the patient care team? Do you feel that your ability to provide patient care properly as an RT if you were working in, say, a Russian hospital where everything is in Russian and the majority of the people (patients and care providers included) do not speak English? PS. Still waiting for the evidence that I'm racist, homophobic bigot. Edit: Actually, screw it. There's no sense in trying to have an adult conversation with someone who has to resort to ad hominem attacks.

...but this conversation isn't about bilingual providers. It's about providers who lack even a working understanding of English. How many dispatchers in Florida do not speak English? I must have missed the national "Disney ticket seller certification exam." Also, I'm willing to bet dollars to donuts that the employees at Disney that work with guests speak English in addition to any other language they know. ...and, yes. I would love to see my racist, classist, homophobic comments where I even came close imply that I only consider some skin colors, socioeconomic classes, political affiliations, or sexual orientations as being worthy of being American. In fact, if this is the route you want to take, I see no sense in continuing this conversation until proof is shown that that is how I view America. I'm all for open discussion and don't expect everyone to agree with me, however I'm not going to be libeled in the process.

If I, as a patient, speak two languages and a service provider (any service including health care) has the ability to provide an employee who speaks the language that I'm more comfortable with, then it's better to provide that bilingual service. If a person only speaks one language, than that one language is, by default, their preferred language. I completely agree that there should be a provider who speaks the patient's language in addition to English. However, just because an ambulance is primarily interfacility doesn't mean that that unit is never going to be involved in an emergency call. Both of the two companies that I've worked for were IFT companies, however at both companies I ran calls going from health care facilities (and every so often private residences) to emergency departments. In my experience, the difference between IFT and 911 isn't as clear cut as IFTs never run emergency calls and companies with 911 contracts only run emergency calls. ...and I'm the one getting testy? Where have I ever said or implied that all Americans are white, middle class, heterosexual Republicans? I would really love a reference to a post where I said or implied something along the lines of "Zomg, I hate dem gay libtards! They need to keep outa my 'bulance!" However, last time I checked, being able to speak English is a condition of citizenship for individuals going through naturalization.

I just reviewed the entire thread and those replies can fall into one of two categories. Either it doesn't matter if an EMT doesn't speak English because it's just a just a tech certification or that it doesn't matter if an EMT doesn't speak English. While yes, I agree that if at all possible health care teams at any level (hospital, prehospital, out of hospital, etc) should be able to communicate to the patient in the patient's preferred language. However, there's still going to be communication issues if the information from the patient can't be translated to the dominate language of the team. Sure, the EMT that speaks English can give report, however if the history provided by the patient can't be translated into English (since this thread isn't about bilingual providers but having a provider who speaks a language other than English and not in addition to English), then that patient care report isn't going to have any additional information in it anyways. As I posted earlier, I seriously doubt my ability to go to, say, Italy or Mexico and get a job in EMS since I don't speak the local language. Sure, there may be pockets of people who speak primarily English, however that doesn't mean that the people I'm working with professionally will be able to speak English as well. I was confused by the use of the term "medical license." I don't expect each and every health care profession to be discussed, however a medical license isn't a generic term.

So what happens when the Hatian that doesn't speak English needs to give report at a facility? Is s/he always going to be paired up with a bilingual partner? While true, the implication of your post is wrong since it implies that PR medical graduates are considered to be a foreign medical graduate. Graduates from Pounce and University of Puerto Rico are considered to be US medical graduates and if they take the USMLE (which is only offered in English), then they can gain practice rights in any state of the union.

Kinda of scary considering that the NCSBN's analysis is 'Err... we don't really know if it's equivalent or not.'

Does Puerto Rico have it's own nurse licensing exam? Puerto Rican medical schools are accredited by the same body, and considered the same, as a US medical school (in contrast to other Caribbean medical schools like Ross or St. George).

Unless you provided the paramedics for clinicals, or EMS in Mexico has jumped by leaps in bounds the last couple years, your paramedic interns might be the most educated provider on the ambulance.

The difference between dispatch CC (P section) and real CC (HPI in S section) is why I've got both listed, but in different areas. Accident conditions would fall into HPI.

If I was to return to the field today, and after having SOAP beaten into me along with all of it's subsections, I'd use a modified SOAP note that I call "PSOAPD" Prearrival: Dispatched code ____ for a complaint of _____. Insert any other important prearrival (wrong address, caught at a railroad crossing, etc). Subjective: History of Present Illness: (34 y/o male presents with a C/C of _____. OPQRST. History/allergies/medication that are directly related to the complaint) Allergies (including reaction if possible) Medications Medical History Surgical History Family History (if appropriate) Social History- (as appropriate) tobacco, alcohol, recreational drugs, sexual history. Review of systems General HEENT (head, ears, eyes, nose, throat) Neck Resp Cardiovascular Abdomen GU/GI Musculskeletal Skin Neuro Psych Objective: Physical exam following same organization as the review of system Assessment: DDx/protocol being followed Plan: treatments Delta: Changes in route, additional treatments due to changes.

So I should be able to go to France and complain when they expect me to speak French? Mexico and Spanish? China and Chinese? The UK and what ever language they speak while claiming it to be "English?" If you're seeking a professional certification or licensure in a country then you should be expected to speak the primary language. Even medical students at the schools in Puerto Rico take the USMLE in English even though their classes are split between English and Spanish and their primary patient population speaks Spanish. When you work in something like medicine, you need to be able to effectively communicate with the other professionals that you work with.

I know that psychiatric disorders have been associated with measurable neurological changes. For example, bipolar disorder and schizophrenia have been associated with a decrease in sensory gating when compared to non-affected individuals.

Beta blockers have been shown to prevent PTSD as well, however it's been decried by some (including the government) because of fear that preventing PTSD would also cause people to lose their memory. To the best of my knowledge, this concern hasn't been shown to actually happen.

Aren't the marines the red headed step child of the navy?

Wow... make sure you remember to refuel your DeLorean.

Well, heck. We're talking about a county where the standing orders prior to base hospital contact can be written on an entire two pages. http://ems.dhs.lacounty.gov/policies/Ref800/806-1.pdf

Now imagine the chaos if they didn't have online medical control directing almost every action and protocols that read like a cook book?

Citation needed. Heck, in the first year of medical school I've already had an entire lecture on reactive oxygen species, so sorry if I seem a little skeptical that oxygen is the end all, be all, cure all treatment that should be given out like candy.