JPINFV

How often do you wash your hands? I tried to wash my hands or use hand sanitizer between every call. That, unfortunately, didn't always happen. How often do you change gloves? Extremely often. I always [99% of the time on the ambulance] wore gloves when touching a patient and always [100%] removed them prior to doing paperwork/getting out of the ambulance/etc. I did get into the habit of changing gloves then doing paperwork so that if something happened I could work on the patient while keeping my paperwork as clean as can be. Do you walk outside the patient room still wearing gloves? If I did, which happened from time to time since half of have SNF nurses couldn't be concerned enough to go to the room, I was conscious of where my hands where and did my best not to touch anything. Do you go to the nurses' station still wearing the gloves you touched the patient with? Only if I need to ask a question or request assistance. If I'm getting/giving paperwork, getting a signature, or anything where I wasn't going to be returning immediately to the patient, then I didn't. Do you make notes with a pen on your gloves? No. Do you wipe your pen and stethoscope with a disinfectant before putting it back in your pocket or around your neck? Not as much/often as I should have. From time to time I did. Do you reach in your jacket or pants pocket with gloved hands during patient care? No. I didn't carry anything outside of extra gloves that I would need anyways in my pockets. Do you consider your gloves dirty only if visibly soiled? Gloves are soiled by default after they touch the patient. Visibly soiled gloves were handled with more concern though. Do you clean the steering wheel frequently? When I was driving, I tried [75%+] to wipe down all of the front [steering wheel, microphone, dash, seatbelt] at the start of the shift. I never wore gloves while driving though, clean gloves or dirty. Do you wear long sleeved shirts? No, see below. Do you wear a jacket? From time to time depending on the weather, less than 25% of the time. How often do you launder your jacket? Rarely. Do you treat all patients with the same infection potential either for their safety or others? Standard precautions were used at all times. Additional precautions dependent on the patient's history [MRSA/VRE/etc] as well as symptoms [vomiting+possible airway management concern=glove/gown/goggles] Do you wear a mask if you have a cold around an immunosuppressed or elderly patient? No. The ambulance didn't have enough masks on board to make this a realistic possibility to begin with.

Watching the second one brought back bad memories of 60 Hz cycling and EEGs.

I just wanted to point out to those reading this thread that it was just resuscitated from a year and a half of asystole.

Not exactly. The vast majority of constitutional rights in the United States are so called "negative rights." Freedom of speech is not a carte blanch right, in part, because it is not written anything like "Citizens shall have freedom of speech." If it was, for example, then EMT-City Admin would be violating my rights by editing or deleting any of my posts. Instead, it is specifically written that the US government shall not make a law abridging freedom of speech. Therefore, only the government is not allowed to curtail a person's free speech. By wording it this way, the only burden of restriction is on the government. One of the few, if not the only, positive right, is jury duty. By requiring jurors, the right requires the work of other people. It is in this sense that a "right" to health care is comparable to jury duty. Health care can not just be made into existence similar to negative rights, but can only come into being by requiring the work of someone else. While I am, arguable, light in the psychology department, just because one person says something doesn't mean that it's the end all and be all in terms of how a government should function. Well, there are police departments that are starting to charge for calls after a certain number of calls every year. http://www.foxnews.com/story/0,2933,324650,00.html If a government department can cover their costs on their own, then there is no reason why they should not do so. Not all police services are free [or else the FBI/California DOJ/ and UC, Irvine police department owes me $100 for my background checks]. Charging for services rendered does make sense.

Well, if there are no basics then what basics could or couldn't do would be a moot point. Edit: Let me clarify a bit also. Stating that the EMT-B level is undereducated is a criticism of the system itself, not the individual providers.

See, the problem though is that the argument is going to be that EMT-Basics shouldn't be allowed in the field unsupervised [online/standing medical control is not supervision] to begin with. With a minimum of 110 hours of training [per DOT standards], which includes only two hours of A/P and one hour of pharmacology, it is very hard to argue that EMT-Bs should be granted a higher scope of practice. With out a higher scope of practice [the level of education of a level should justifies their scope and a level's scope of practice is what makes them beneficial to a patient], the ability for EMT-B personal to care for a patient past high flow O2 and transport is extremely limited. See the following examples: A call to arms! EMT-B's defend yourself! Basics and Intermediates ONLY No more BLS 911 ambulances?

Foramen ovale for the loss [yes, I have an anatomy exam on Friday...].

The problem, though, is that you need a strong educational background to build those experiences and habits off of. Unfortunately, EMT-Basic courses, in general, do a very poor job at this and there is no way that someone who hasn't even graduated high school yet has this base. This is why there should be at least an associates degree to enter EMS. Not a 120 hour (give or take) advanced first aid course.

That only covers them for liability, but doesn't give them the same authorization that something like standing orders would give.

The treatment might be the same, but the assessment, and the conclusions drawn from that assessment which dictates treatment, might be very different. The average provider with 30 years simply has more experience and more education (CEs and, hopefully, more formal education) than a person with 1 year of experience.

Whoa, wait a minute. Since I'm running this experiment, I can't participate as a subject. 8)

You know, I think we should run a study through EMT-City to find out the best insertion techniques and the optimal EtOH concentration. Any volunteers?

Don't you think that people who are in high school and in an EMT-B course concurrently are a little biased on their opinion?

Since it looks like most people that have been participating have it down, the answer is Saturday Night Palsy. This condition is one of the clinical correlates in my anatomy class. Saturday Night Palsy [aka Honeymooner's Palsy or official as Radial Nerve Palsy] occurs when pressure is applied over several hours to the radial nerve causing necrosis. An example of such an event could happen if you pass out with your arm hung over a chair. This is because the radial nerve spirals around the medial part of the humerus after giving off its branches for the upper arm. Therefore, damage to the nerve, which can be permanent, will affect the muscles of the top/dorsal part of the hand that engage in extending the fingers and the wrist. One of the tell-tale signs of radial nerve damage is called "wrist drop" (hold your arm out straight with your palm down and relax your wrist). Other muscles in the hand can weakly extend the fingers, though, and are innervated by a different nerve. http://www.emedicine.com/neuro/topic587.htm

I guess this is one way to "get a little captain in ya."

That might be something that only people in your area will know. You might want to contact your state or county office of EMS. [hr:b4a47ffe65] While I agree that more hours should lead to a better education [it depends on how the course utilizes that extra time], 50 hours is hardly enough to satisfy the extra time that should be required for Basics. It also isn't nearly enough for the people who like to go "Well, MY class was X hours longer than 120 hours so you fail." More hours is definitely moving in the right direction, but it's hardly enough to be considered better than someone who took a shorter class.

While I can't offer any sort of analysis on the program quality or the reasons behind the cost, it is important to note that EMS education is based off of clock hours of class time and not length of the course. The first program, roughly calculated, has about 192 course hours (given an hour for lunch each day), while the other course has 144 course hours. Honestly, I don't feel that 50 hours is really that much more time. It's only about 8-9 more days of classwork [2 weeks using their schedule]. Essentially both are the same length, just one is spread out over several more months and is more friendly to working adults and college students.

Blood pressure is equal in both arms. Negative swelling or tenderness. [hr:d036958162] Sunday :!: :wink: [hr:d036958162] The patient doesn't remember how he fell asleep. [hr:d036958162] His last final of the term was on Friday.

The sad part is that there are plenty of systems that require a long radio report. Orange County, CA, for example, requires the medic units to essentially repeat their entire PCR to the MICN [the MICN calls the receiving facility when contact is made. There is a criteria for "ALS No Contact" though which involves the medics reporting directly to the receiving facility]. For BLS calls, though, it was age, sex, PMD, CC, ETA, and pertinent info [not normally needed though].

You wait 15 minutes and there's no change in sensory or motor function of the arm.

He doesn't really remember where he fell asleep, but he woke up in his desk chair. The paralysis isn't fading even though he's been up longer than 30 minutes by now.

At least the tazer won't kill most people.