JPINFV

I require the name of this school. I'll add it to my list to send some money (attached to my secondary application. Secondary applications=extortion) next year.

I can think of a few reasons why people would push for a minimum of 21 to work on an ambulance. 1. Have you ever worked with a partner of the same cert level that couldn't drive? It sucks running calls all day where you either have to attend all calls or drive all day. Being able to switch between driving and attending is nice, as well as being able to put the person with special experience in the back for more difficult patients (psych patients, for example). Sure, this is a non-issue if you're working a basic/paramedic truck, but basic/basic or paramedic/paramedic combinations are a different subject. 1.A. Driving There's a reason that my insurance dropped from $200/month to $100/month when I turned 21 and I am getting a late insurance Christmas present this year of another $10/month discount (full coverage, no accidents, no moving violations). As much as I think that this is age and sex discrimination (young people don't have an AARP to keep our rates low), I can see why this is the case. It was sad the amount of people at my last ambulance job that was paying $200/month or higher for liability insurance. Older=more mature and more driving experience=better driver=less likely to kill everyone on board in an accident. 2. Education. A lot of people here would love to see at least an associates degree before being able to step onto an ambulance as a crew member, especially as the one responsible for patient care. If you can't start working till you become 20, but can start your education at 18, then you will be able to fill that time with a proper education (Basic education =/= education in the slightest sense).

Volly vs Paid: Check Union vs non-union: Stay tuned EMT-B v EMT-P: Still waiting. Ultimate Thread of Ultimate Destiny almost complete.

So California is requiring all fitness centers to have AEDs as well as having x amount of employees trained to use them. Most of the bill itself looks to be more semantics/clarifications than actual changes (for example, changing the fitness center's emergency response system to an emergency response plan as well as requiring a medical director instead of a prescribing physician). Unless I missed something from when I read over it last night, it really doesn't look to be affecting ambulance operations very much, if at all.

Woohoo... something to occupy me over break! Would it be a proper assumption that this should be an ALS ambulance?

I'm not dead yet.

How would you explain the lack of such problems (to the extent that it occurs in EMS at least) in other health care fields that don't resort to such a regimented educational style?

I don't know if it's because of my experience growing up, or going through a different educational setup, but I expect schools to teach me information and help develop critical thinking and evaluation skills instead of behavior. Honestly, I don't want my time wasted while an instructor teaches someone how to dress themself or how to be respectful, even in disagreement. If a class is supposed to start at noon, start it at noon. If it's supposed to start at 11:55, start it at 11:55. That's different than expecting someone to arrive at 11:55 and sit around for 5 minutes chit chatting or otherwise till the class starts. I can see, however, how late arrivals could pose more of a distraction for a class room enviroment vs a lecture hall enviroment, and I respect that. Requiring everyone to arrive 5 minutes early, though, is not the answer. I will admit that my experience is limited too. I've never attended a community college (ignoring EMT refresher course). It might have to do with admission standards (anyone can enroll in a comunity college) that acts to filiter the student population that I've been exposed too. Similarly, you aren't going to get people paying 10-30k/year plus living expense through loans to go to class and waste time. Sure, people get giggly over some of the subject matter (the profs aren't helping at times, but that makes it interesting and it doesn't detract enough time to impact the educational experience. In times it enhances it). Due to that, I find the sort of paramilitary education (and company organization. All the senior management people at my last company wore military rank lapel pins. I still laugh at that) just a little queer. Point taken. Being a tad out of shape, I don't think I can argue with a little PT. Marching around with flags, on the other hand, eludes me as something that would assist a person's entrance to paramedicine. This isn't the military where there is a need to develop a commitment to a soldiers unit and the such. Just as it isn't a provider's duty to take any command or order as gospel and not question it unless it was completely immoral. Similarly, as with the above class (my company was involved with their basic program's ambulance clinicals), I fail to see the need to have patches, epaulets, and the rest of the pomp and cirmcumstance that goes with a paramilitary education system (I view paramilitary style education as a complete package). The problem is that I fail to see how the clothes I wear in lecture affects how I learn, and thus how I care for my patients. I don't believe that either necessarily creates a better end product, but I can see a more regimented style pushing away students used to a more relaxed system. Afterall, why should I dress up more for a paramedic teaching a class than I would when a MD or PhD is teaching a class? Similarly, I'm curious as to what part of the magic formula EMS is missing that other health care fields aren't that forces EMS to take this measure to [poorly] weed out the trash? Would moving paramedic programs to lower tiered state universities (for people familiar with California, by lower tier I'm thinking about California State vs University of California) and out of community colleges help to weed out people who have no busniess in health care?

Zero tolerance requires zero thought and zero throught has no place in any educational institution. Technically speaking, I should have been suspended in high school because I took a lighter to school several times. A lighter is considered "drug paraphanalia," and thus is supposed to fall under zero tolerance guidelines. It wasn't supposed to matter that I had an actual reason to have one (band, will elaborate further if need be), but the vice prinicapal of supervision was ok with it as long as I didn't get flashy with it.

Just wondering, how much of your time in culinary arts school was spent in the kitchen? I can understand a uniform requirment when there is a reason (cleanliness in the kitchen for example). It's like you can tell when the medical students have their interviewing class because they're in "uniform" (slacks, collared shirt, short lab coat), but if all they have are lectures, then they wear comfortable clothes. There's also no behavior modification, so to speak, in medical school. Of course medical school is a place far removed from even undergrad. No one really cares if the med students show up and all of they're lectures are recorded and posted online. It seems to be more about education than mindless rules. (as someone else posted earlier, the door is locked at 5 minutes before class?!?).

I'd rather read one sentence paragraphs than a solid wall of text where every sentence is a different point.

I was using the uniform as an example, but listening to peoples' stories and looking at some of the videos from the local paramedic courses in Orange County (Riverside Community: http://www.youtube.com/watch?v=Kev2Sn42tUc), it looks like regimental drills are more important that an actual solid education at times.

Just make sure that there's a good number of SNFs, dialysis clinicals, and a hospital somewhere along the line and it should have plenty of busniess.

The first thing that I would do would be to put money towards a new base of operations. When I left the company, there were over thirty-five units that were not assigned to 24-hour units. There was literally no more space in the building to store units, so units were being stored outside. In addition, there were only a handful of parking spots available, not nearly enough for the amount of workers (billing, dispatch, executives, wheelchair van drivers, EMTs) that were expected to show up. This was compounded by the fact that the building was in a light industrial section of the city, so street parking was very limited too. Furthermore, dispatch was overflowing with people (2 ambulance dispatchers, 1 wheelchair van dispatcher, several call takers) to the point that some of the call takers were being moved out of dispatch. With out a larger base of operations, any sort of expansion would be painful, at best, impossible at worse. In addition, this would allow more space for training and the like. Second, I would increase the budget for crew chiefs while increasing their responsibilities. In the two years that I worked at my old company, I received almost zero feedback after clearing field training. By zero, I mean nothing. No praise, no criticism. Never once did a crew chief show up on a call to observe. Not once did I receive a PCR back with comments. It seemed (albeit I never was one) that the crew chief's job was to make sure everyone showed up and got out on time, go around collecting back boards, and sit around for a few hours in case something happened and then go home. Next, I would increase starting page at least another dollar as well as liberally give raises across the board to reflect the new starting wage. Nothing is worse than working for a raise only to see it "wiped away" when everyone else gets a raise a few months later and you're back to what is considered a starting wage. I say giving the dollar wages "liberally" because I don't want to reward incompetence, but this would be a case were meidocracy would merit at least a small raise. Increasing the pay would help to round out the department. There was simply not enough people working when I was there and this took a toll on crew morale, and subsequently crew behavior (destroying equipment, bad patient care, etc). It doesn't matter how much you get paid if you are working 12 hour shifts constantly without a break. Finally, I would implement an electronic PCR system. I believe that electronic PCRs would benifit the company by increasing PCR compliance and make QA easier. This would have an additional effect of insuring that the fields required to reimbursment are filled out. I would make sure to budge enough money to include paying a premium for durability (must be able to survive in a company that has over 80k calls for service (non-emergent, emergent, and critical care transports) a year), technical support services, and other necessary accessories (power cords and printers for every unit, for example).

Personally, I've always found it weird that paramedic courses had a paramilitary structure to them (uniforms, etc). I was wondering, what are the benefits of adopting a paramilitary structure vs other educational structures (ex: what ever structure a state college would be considered)? Also, why do you feel that paramedic programs should be structured this way?

Yet all of those will have to be honed while working on real patients as a basic. The only difference is that basics have an even more substandard educational/clinical experience before being certified/licensed (yes, I am licensed as a basic. Well, techincally, I'm licensed as an "ambulance attendant," but the prereq for that is my EMT-B cert) to work off of. Saying that EMT-B experience is needed is flawed on the simple basis that EMT-Bs aren't expected/required to have an educational base that could be built upon by experience.

Peanut butter sandwich: A biochemical prospective The bread of the sandwich contains carbohydrates (sugar) and are broken down and manipulated until they reach a glycolytic intermediate. At this stage, they can either be used to produce ATP (glycolysis) or glucose (gluconeogenesis) depending on the bodies needs. The end stage of glycolysis is pyruvate. Again, depending on the bodies needs and organ type, pyruvate (after being changed to an intermediate) can either be transported back to the liver for gluconeogenesis, or converted to acetyl-CoA, which can be used for multiple things including fatty acid synthesis and ATP production (TCA/Krebs/Citric Acid cycle). Once a glycolytic intermediate is converted to acetyl CoA, it loses its ability to be converted back to glucose. The protein found in the peanut butter is handled differently, but has the same end product. Protein is broken down into individual amino acids prior to absorption. Once absorbed, amino acids are either used for producing proteins or broken down. Unlike glycose (glycogen, fat [glycerol backbone) and acetyl CoA (fat), amino acids can not be stored in the body. Depending on the type of amino acid, it can either be broken down into a glycolytic intermediate (can be used for gluconeogenesis, called a glycolytic amino acid), can be made into a TCA cycle intermediate (called a ketogenic amino acid and only includes leucine and lysine), or can be made into both (example phenylalanine/tyrosine gives off two products, one in each category).

It took me a bit to figure out a definition that worked, but I believe that it means acute pulmonary edema.

First off, if at all possible, please include the names of the people that you are quoting in at least the first quote section. You're quoting from multiple people in that response and it makes it a little hard to track who you're responding too. Returned home and limited deficits.

EMT-B is useful as a first responder certification, not as a solo provider license/cert. This is a conversation for a completely different thread, though, as well as being a dead horse topic here. My concern isn't over if they are/aren't requiring it, but the reasons given for their change in admission requirements. If the stated reason was, "We don't see the utility of requiring EMT-B prior to entry to the academy" or "We'd like to have better control over the quality of EMT-B education" then I'd say that it was a good idea. Watering down the requirements to foster "diversity" is just plain stupid. If they're willing to over look a requirement because of the amount of melanin someone's skin cells have, then I question what other requirements and traits that they are willing to overlook.

[sarcasm] You know, since this profession is so dangerous, wouldn't it be best to have PD sent to all of our calls, just in case? After all, our "brothers and sisters in public safety" should be more than willing to go to all of our calls, right? I mean, you never know when you're going to need the police and this would cut down on the danger we face. Actually, let's go a step further and merge EMS with police. Since we'd all be police officers, that should solve the problem. [/sarcasm] I've never been attacked by a psych patient. Listening to how a lot of my coworkers thought about (your feelings will affect treatment, maybe not overtly, but it will affect your actions unconsciously (tone of voice, word choice, etc) and treated psych patients, it honestly does not surprise me that people get attacked from time to time.

Keep the number of ambulances and EMS professionals low and people will die also. Personally, I'd rather have more ambulances than fire engines. The ambulances get used much more often for their intended use (I still have never understood why fire departments send engines to medical aid calls). Delaying EMS due to limited material and professionals will kill more people than delaying fire responses. By the way, nice appeal to ridicule there at the end. I am not going to comment on the negatives you noticed with the crew you were with, but as to why the Fire Medics might have been more aggressive, etc....... The fire service is, by definition, an agressive orgnization. We crawl into burning building while the rats are crawling over us to get out. You have to be aggressive. Or just plain nuts.

Ahh, just checking. It just wasn't called that at my undergrad. The bio upper division writing was just called the ambiguous Bio 100LW: Experiment Biology Lab with the lower division being "Critical Reading and Rhetoric" (mumbo jumbo that no one really cared about to be honest) and "Argument and Research" (which equated to "progressive ideas" being shoved down our collective throats because it was based on the book Nickel and Dimed when I took it. It looks like they've moved on to 9/11, because, you know, university students are too stupid to just pick a topic that interests them).