JPINFV

What did paragraphs ever do to you to make you hate them so much? Making peoples' eyes bleed by confronting them with a wall of text is not a good way to start a thread. Now with paragraphs. They have to be certified through a government agency somehow. Furthermore, if any of the fractures could be attributed to the transport, you could go for malpractice (splinting in the ambulance instead of on scene? Dude, take a minute and walk your [the EMT, not the original poster] fat ass back outside and get your own damn kling and splinting material, or have the police officer go and get it. For bonus points, get a few ice packs while your at it). Alas, I fear that any action would ultimately require much more work than it's worth outside of a strongly worded letter to the certifying agency.

That is the only thing I can think of. Any loss of circulation (which evolution and God has done a good job of building redundancy into the circulatory system) will cause two rings of damage. This is similar to any ischemic event, though (stroke, MI, cardiac arrest, etc). The cells nearest the loss of circulation will die via necrosis and there is no real way of stopping, slowing, or preventing this outside of reestablishing profusion as fast as possible. In the area around these cells and completely unaffected cells is an area of cells that will die via apoptosis. It is this cellular process that can be slowed down and, providing reestablishment of profusion, reversed. This is the reasoning behind induced hypothermia following a cardiac arrest.

Ok, I'll ask. What drugs are you able to administer to a cardiac patient besides oxygen? How about patients with shortness of breath? Can basics in your area start IVs? How about intubate with an endotracheal tube? Again, just because you and your friends are superstar EMT-Bs who go above and beyond the call of duty in terms of education does not mean that the percentage of EMT-Bs that do so are representative enough to be able to justify a larger scope of practice. In my area, EMT-Bs are limited to O2, positioning, and vital signs as an independent provider. That's not much to offer, unless you are also counting all of the paramedic assist "skills" like hooking up a monitor and priming an IV. Those "skills" [quotation marks because they aren't really hard] can be taught in less than 5 minutes.

While I believe that it's normally bad form to link to other forum discussions (ex: I wouldn't link this forum to another EMS forum and vice versa), I think that it's different when discussing things that fall, in part, out of the purview of the original forum. The Emergency Medicine Resident Forum over at Student Doctor Network had a lively discussion over this already. Man sodomized in NYC ED Funny related image, not safe for non-medical jobs. [spoil:fd79a04062][web:fd79a04062]http://forums.studentdoctor.net/attachment.php?attachmentid=6948&d=1159498478[/web:fd79a04062][/spoil:fd79a04062]

^ That said, looking at your occupation, you can do a lot more with an airframe and power plant license than you can with a paramedic cert. That said, my dad is kinda of a far outlier when it comes with careers based on an A and P cert.

Why? Is it wrong for an EMT-B to agree with him that EMT-Bs are woefully under educated for what is being asked of them as a primary provider? Is it wrong to agree that two of the biggest road blocks to increasing the required education are EMS based fire suppression systems (who don't want their firefighters in school for a long time) or volunteers (who complain that if school was too long that they'd have a larger problem attracting volunteers)? The problem is that by the time you need BCLS, it's already too late. EMS does not save cardiac arrests. EMS saves pre-arrest patients by keeping them from going into arrest. EMT-Bs, by the nature of their limited scope of practice [i will argue that medical care is, in large part, skills because all the education in the world will do you no good if you can't affect the outcome], are very poor at keeping pre-arrest patients from going into arrest. Its very hard to argue that EMT-Bs should have a larger scope of practice, though, when the average EMT-B has something less than 150 hours of class time. The fact that an EMT-B program requires more time is irrelevant because things like scopes of practice are geared towards the lowest common denominator, not the high outliers. It is my understanding that most volunteers are EMT-Bs. See above for why EMT-Bs should not be considered as a primary provider. Furthermore, how often do you hear about paid providers crashing their POV while responding to a call with their hazard lights on? How often to paid providers respond in jeans and a t-shirt? Yes, unprofessionalism is, rightfully so most of the time, also charged against EMT-Bs working interfacility transport [non-emergency transport] jobs. There has also been calls made by Dust and "Dust groupies" that such jobs do not fall into the realm of EMS and need not, and should not, be done by ambulances. Thank Medicare, though, for not reimbursing gurney vans. There are somethings that can be a priori. You don't need evidence to show that the level of care provided by EMT-Bs are vastly inferior to the care provided by EMT-Ps. Now, saying that one level is below another is not a bash on members of the lower level. That's like saying that NPs and PAs should be aghast that they have to work under a physician ("collaborate" and "supervise" are the specific terms if I understand the physician/mid-level provider relationship properly). That's not to say that NPs or PAs are stupid. That said, there is a vast difference between comparing master degree level provider positions to a 120 hour provider position. There's a difference between "EMT-Bs are ignorant and shouldn't be on an ambulance" and "EMT-Bs are ignorant and shouldn't be on an ambulance because EMT-B school isn't long enough to cover material like A/P, pathophysiology, and other supporting fields of study (biochem, etc) long enough to provide an adequate knowledge base and justify a large enough scope of practice." One is a slam, the other is an argument. Just because an argument is negative doesn't mean that it's a slam. I'm sure that, in large part, he's being sarcastic. Sure, I'd take a hot partner than a fat old man any day of the week, provided that both providers offered a reasonable and comparable level of care. That said, 18 year olds are perfectly legal adult teenagers.

As a general rule, you should only be using 1 conjunction per sentence. Stringing together 5 different statements into the same sentence is a good way to make people's eyes bleed.

People still use fully automatic AEDs? I thought those fell out of favor in the mid-90's because it's safer to control when the shock is administered [i.e. push for analyze then push for shock if indicated. Not pushing to analyze and shock at the same time].

He was just performing a complete assessment, like in this case [Man forced to have a digital rectal exam].

WOW? World of Wimps? /Eve-Online player

Yawningly

training

Inn

The EMT-Intermediate level is essentially not used in California (it's several restricted [considered "Limited ALS"] and they're trying to move it towards modular additions to the EMT-B level). In California nomenclature, an EMT-I stands for "EMT-One" and is the same as an NREMT-B. Intermediates go by the term EMT-II which stands for "EMT-Two."

LA County Treatment Protocol Page The EMT-I (reads EMT-"one") is the BLS protocol for LA County. Orange County's EMT-P Protocol Page Orange County is just South of LA county. There isn't a protocol for Basics written down though.

The high schools where I grew up work in conjunction with Regional Occupational Programs (ROP) (including EMT-B and medical first responder. The first responder course is a pre-req for high school students, but waived for adults) that junior and seniors are eligible to take. These courses are graded for the students and take the place of 1 class period (so they still have to take, at minimum, 4 other courses). The EMT-B course is only opened to seniors, and it is preferred that students turn 18 before the end of the course so that they will be eligible to take the NREMT Basic exam.

No, but the service I worked for used 75+% metal O2 wrenches. What is maddening, though, is when people over tighten O2 tanks (talking about people literally using the O2 wrench to gain leverage on the regulator clamp screw (thingamajig)) or using a wrench with a hole a little wider than the knob and overtightening it to the point of tweaking the metal so that an O2 wrench won't fit properly. Of course these tanks were considered good enough to go out, even if it took 5 minutes to figure out just how to angle the O2 wrench to open/close the tank. I loathe crew chiefs who think their job rests only on getting crews out, regardless of their equipment status.

Diagnosis Wenckebach? That AV node don't know how to act...

At least they used a simple mask so they didn't have to worry about the bag being empty.

So, you need a class to teach you how to dress?

I've always said that if you can't dress yourself, you shouldn't be on an ambulance. As I've said in other threads, if uniforms are such a necessity to produce "professionals," how come most undergraduate, graduate, and professional degree programs out there (including, but not limited to, medical school) adopt them also?

I see your wink, but... There's an O2 wrench attached to all of the unit keys. Besides that, it was busy enough that we always left the portable "charged." Does anyone actually unpressurized their regulators between calls?

Well, since we're starting up the O2 errors, my favorite is trying to pull a patient out of the ambulance and forgetting to switch from the main tank to the pony.

When I worked on the ambulance, all I carried with me was my shears, pen, gloves (in my pocket, company pager and my cell phone. I used to carry a pen light, but after I lost my second one I stopped carrying it. I also had a backpack with a DVD player and DVDs as well as a "mandated reporter" pack that I made (protocol+form+stamped/adressed envelope. I actually did use it once too). In my clipboard I carried a little protocol pack that I put together to deal with idiot partners (DNR protocol was different than how it's normally taught) and transport protocol (for the RNs that like to insist that we call medics when were less than 5 minutes from the hospital). At the water park, I carried a 2 way radio, shears, and a fanny pack (required for all CPR/first aid trained employees. The EMT-Bs could put what ever they wanted in it from the stock room as long as they had a CPR mask and a glove/gauze pack).

It really depends on where in LA county. Orange County's EMS scene is worse than LA's. At least LA County allows the private companies to employ paramedics and will use private company paramedics if they are overwhelmed. Besides that, Orange and LA Counties both run similar systems in the sense of a lot of communities provide paramedics through the fire department while contracting out the actual transport (ambulance + 2 EMT-Bs) to private companies.