James_ffemt

It is truly amazing to me that a person asks a simple question and gets bashed. I read through these posts and see this allot. Is that all you guys have to do? This site is supposed to be for resources and to educate, but obviously all anyone wants to do is make fun and bash people when they ask questions. Maybe each one of you that do this need to step back and take a look at yourself. Where any of you in the same spot previously that the ones you are bashing are right now? Where you ever a newbie? Did or have you ever asked a question that you wanted a answer to and someone gave you shit about asking the question? I would hope that the administrator would do something about the negative comments that occur when someone asks a question on this site. Just remember guys, turn about is fair play and one day you will get yours!!!

Well for what its worth I had back surgery 5 years ago in Feb. They fused L4 and L5 by taking bone off of my left hip and I have 2 "U Bolts" on either side of my spine. The damage came from so many years in the funeral business lifting the stiff ones by myself and wrestling them onto the embalming table by myself. Once I recovered fully from my surgery I have been able to do anything I want. I lift those 300 pounders and pick them up off the floor. Granted I only work part time I still do my share of lifting and have had no problems. Like others I am sore at the end of the shift but I think that in part to your back not getting enough rest because your busy for 24 hours. It can be done with back problems, just remember you only have one back and you want to take care of it.

Ridryder 911 I understand what you are saying. You and I both being from Oklahoma, do you ever think that will happen? I don't, but what's your take as far as Oklahoma goes.

How many of you use a are finger to feel for the vein. I have worked with a lot of older medics that will take the tip of their glove and tear it off so they can feel better. To me, not good BSI practice. I even have seen nurses at the ER do this or not use gloves at all. What's your thoughts?

"don't worry, if this doesn't work out for you, I'll see you in my funeral home. My second job is a funeral director" Funny thing is, I waited until I got out of the funeral business before I went to EMT school. Felt like it was a conflict of interest. Though I do find that my A&P that I took in mortuary school has helped allot and I know that if my medic or the ER Doc needed to do a femoral cut down I could find it really quick. LOL

Ok, I'm not saying that I want basics to start IV's or give medications. Just want opinions on if you think it's better to have a line established in case the nitro drops the bp. We are allowed to give nitro after checking for contraindications. My concern is, why the hell do I want to give a medication that could potentially kill the pt if their bp drops and I have no way of getting it back up like paramedics do. I understand calling for ALS if it's a cardiac call but ALS is not always available. Again, I am looking for further knowledge on what you guys (paramedics) would rather see when nitro is delivered. (IV established or not) and why.

I was just wanting some input on what everyone thinks about EMT-B's giving nitro. Here in Oklahoma Basics are not allowed to start IV's. It has been mentioned to me that it is a good idea to have a line established when administering nitro in case bp decreases. You guys give your opinion on nitro administration with and without a line established.

JR

Dances With Wolves

Glitter

Winter

Terri

off

Stripper

fishing

Dirt

LAZY

Wilbour

These are the types of replies I hoped for. I was not sure I did the right or wrong thing by waiting on the truck to arrive. I will say that the 8-10 minute ETA for the second truck was established as soon as we arrived on scene. I helped my paramedic package the more critical patient first. (EMT-B/FF was with pt. who was still in car.) Once the critical pt. was in the ambulance I went to the pt. in the car and obtained baseline vital, SAMPLE, etc. I also placed the pt. on O2 while she was in the car. I have no idea how long all of this took, but I would say 6 min. or so. KED would have been a great choice. Once the other crew arrived, I gave a report to the medic and he released me to help my partner so that we could get to the LZ. I think this scenario could have been handled many different way depending on many different things. That's why we are all here is to learn and ask questions, so that the next time we will have more knowledge to handle a similar situation differently. Thanks for all the replies.

I feel the same as all of you. I believe he was lazy and didn't want to do his job. Two other paramedics and the supervisor agreed that it was my call and that considering the factors I was right in my decision. Thanks guys!!!!!!!

I would like to know everyone's opinion on what you would do in this situation. Received a call for two vehicle MVA. Upon arrival we find two vehicles with major damage. One of the vehicles (#1) has been T-boned on the drivers side and pushed into a telephone pole causing about 40% intrusion on passenger side. Windshield is spiderwebed and also broken out on one side. Car #2 has significant front end damage. Driver of car #1 is lying outside of vehicle on ground upon arrival with a deputy (also paramedic) holding c-spine (only occupant of vehicle). (We asked and were told that someone drug him out of the car before our arrival. Driver of car #2 (only occupant) is still inside car. My paramedic checked on car #1 pt. and pt complains of pelvic pain and also possible loss of consciousness. I check on driver of car #2. She is complaining of neck, lower back, and left leg pain. Pt. of car #1 is packaged and placed in ambulance. We have called for another unit to transport driver of car #2 because my partner is flying the other guy out from the airport which is close by. I stick with pt. of second car. Collar applied and ff/emt is holding c-spine from back seat. I get a set of vitals. BP 170/110, pulse 98, and respirations are 18 NL. Pt has a history of high bp. She is answering all questions asked. ALS unit that was requested is about 8-10 min out. Ok, so here is the question. The paramedic on the other truck was pissed because I did not move her out of the car onto a LSB and put her in the middle of the street until they arrived. I did not do this because of a couple of reasons. 1. she was hysterical and anytime you acted like you were going to touch her she would scream. 2. It was hot outside and would have even been hotter lying on the blacktop. 3. The only place to put her was right in the middle of the accident scene. The ambulance we were working out of was not big enough to hold two pt's and two medics be in the back. Would you have waited to take her out and place her right into the awaiting ambulance or would you have got her out and put her on the ground and waited? You guys let me know.

Wow... I go to work for 24 hours, make an unscheduled trip to the Cape to visit some family... and look what happens! Everyone has either lost their mind, or completely lost the point. I knew what I was doing when I made this thread, and I'm relatively sure that Dust knew what he was doing when he suggested it. Dust is a very thoughtful individual who is looking for a reason to advance EMS and improve the standards. I do not begrudge him this want, and frankly encourage any and all to sidle up beside him and help further the cause. Unfortunately he and others have made it clear that in their desire to re-vamp EMS, it is going to require the destruction and disbandment of the single largest group of EMS providers. They have all made it clear that they think the majority of BLS providers are bad. You know what? I agree. I think the majority of BLS providers are either in it for the wrong reasons... i.e. Fire Monkey add-on, or lack the in-depth knowledge and social skills (Dust: It IS about the Skills, just not the ones you mean) to perform at a high level. Most EMS personnel in general are people with very little accessory knowledge about life, classical regular educations, business, culture, literature, or even simple life skills like balancing a check-book or holding down a regular job. This is cumbersome for all of us who look to further the abilities of the industry and our systems. What I keep reading here is that even a good basic is more useless than a paramedic, to another paramedic. I believe this statement implies that all paramedics are adequate. I think the issues regarding why EMT-B's are useless applies even more dramatically to the paramedics. Bad Basics make bad paramedics. Regardless of where you started, if you don't have it in you to be a good basic, you cannot be a good paramedic. Most paramedics are just as woeful and sub-standard as all the Basics that run about. The problem here is that we are judging people based on the number of hours in a course. It's not about the course... it's not about the school... it is about the PERSON. The individual makes a good EMT or Paramedic. The schools and the hours and the education is ancillary in nature. If the quality of material being molded is deficient, so will be the final product. So, to answer my own question. A good EMT is similar to a good pharmacist, or a good construction worker, or a good engineer, or a good fighter pilot, or a good WHATEVER PROFESSION YOU CHOOSE. It is someone who tries hard, and thinks harder. Someone who is not satisfied with the education he received in class and didactic, and has taken it into their own hands to learn from their peers (the good and the bad... you can learn something from everyone). A good EMT has good peripheral vision, so that they can constantly watch their partners' back. A good EMT questions orders when appropriate to do so, and has a warning bell always ready to go off in his head when things are about to go wrong on a call. A good EMT knows every application of every piece of equipment in his truck. A good EMT know how to do exactly what his partner is not doing so that you can move with greater efficiency toward the ultimate goal... definitive care. A good EMT knows when his/her partner needs help before the partner needs help. A good EMT knows how to evaluate a patient in a controlled and detailed manner and know not only your own plan of care, but understand your higher level of care partners' plan of care. A good EMT knows how to organize a scene and knows how to utilize every person on that scene to make things run smoothly and efficiently. A good EMT knows how to communicate to a variety of people in a variety of circumstances in an intelligent and focused manner. A good EMT must give respect.. or expect none in return. The answer to everything is education (and the abolition of whackerism). But education alone is not sufficient if the beings getting the education are not capable of absorbing it. The one thing that is always overlooked on these forums is the QUALITY of the person doing the job. We are quick to nay-say the level of certification and all that hold it, but not break it down into fair and appropriate aggregates. One should not say that basics suck, they should say, "Hey! That basic sucks!" - or - "That paramedic sucks!" Because by classifying all basics or all medics together we verge on a new form of bigotry... One of which I will dub... EMS Apartheid. I could go on and on if I chose. But I got to go back to work. I believe I have gotten my point across, if not... then I will just tell everyone that what ever level of provider you are, that you suck. Cheers & Jeers Josh HMMMMMMMM!!!!!! Seem like that is allot of what I said.....

Red, There is a guy on Ebay that makes his own LED lights and is very affordable. I have bought lights to put on my Work Truck (Emergency Management) and have been very pleased. His ID is "ifdtrucky". Give him a try. James

Ok, so here goes..... First of all I do think that EMT-B's are important and so are the EMT-P's. There are many different settings that bot can be utilized in and I think it depends on where you live and what you have to work with. EMT's (basics) are a vital part in the system I work in. Yes we are ambulance drivers and taxi attendants but when it comes down to it we do our job that we are hired for. When I am working I am working with a EMT-P but sometimes there are just two basics on board. When working with a EMT-P I am responsible for vitals, bleeding control, BVM, O2, hooking up leads, etc. I was told a long time ago that when working with someone that has more knowledge than you that you should always try to think ahead and be ready if they ask you for something. I think this should be the same for the EMT-B working with a paramedic. Know what they are going to do next before they do. Working well together is the key to all of this. Having knowledge of the situations we encounter on a day to day basis is good. I have worked with some basics that will load the pt. and go get in the driver's seat until time to head for the ER. Those guys don't need to be working. I enjoy the hell out of my job as and EMT-B. I try to learn as much as so that I can give the best pt. care I can. I feel as long as I do my job within the scope of practice as an EMT-B I take a load off the paramedic I am working with. And, I feel that if I stay a step ahead of him/her that I make things go smoother in the back of the truck. Now, working two basics on the same truck....When you get an ALS call I think all of us have had the pucker factor. But, you just have to do what you can and get the pt. to the ER as soon as possible. In our area we are often short paramedics and can only have two basics. That's rural America for you. The two basics do the best they can and use their training and experience. Now, for those of you that are thinking it...they are not two green basics thrown on a truck with each other. We have 3 or 4 basics with 20+ years experience and many with 5+ years. So we don't have newbies on the truck caring for pt's. In the perfect world we would all become EMT-P's and all trucks would have at least two per truck. Ok, so we don't have a perfect world. The basics that are in it to make a difference in someone's life are a vital part of the EMS system and their Paramedic partner. The one's that are in it just because need to get out. I encourage all basics to stay current on all their skills and know what their partner expects when working an ALS call.

This was just a general question. No scenario. Nothing happened. Just wanted some genuine feedback on this topic.