Newbie EMT here!

[spenac]

Now you give me this advice minus the girls in bikinis the rest sounds great where do I sign up. Oh wait Spenac said I was too OLD to go to med school.

Emtboy you have been given some great advice here just dont let the lure of money and ems glamour distract you from your goal at being the best you can be. You can be the best at anything you choose you can make things happen with 3 of the best qualities all of us possess and seldom use. Those are Blood Sweat and Tears. Good luck on what ever you choose and what ever road you decide to get there.

Sorry as old as you are the only place I could find for you in med school was as a cadaver.

[HERBIE1]

Just to make it more difficult for you I'll throw in my 2 cents. If you want to go to medical school, do not worry about becoming a paramedic. Focus on your premed studies and get the best grades you can. Study hard for your MCATs. Get experience as an EMT while you are an undergrad (it probably won't help your application but it does give you something to talk about during your interviews and also gets you accustomed to dealing with pts and emergencies) and get involved in research. It will take longer than the other routes but you will have a mansion in Beverly Hills, several Lamborghinis, a yacht in the south Pacific and all the super models you can handle (sure beats California EMS).

Interesting comment about going to med school, doc. My wife is in administration at a local University and part of her job is advising preprofessionals looking at med school, pharm school, and dental school. She asked me some time ago about people who thought becoming an EMT or paramedic would help them to get into medical school. I told her the same thing you said- if your heart is already set on med school, go for it and forget EMS. The only caveat I made was to advise the youngest ones(still in high school) who were not sure about their career path to consider prehospital care to get their feet wet in the business. I suggested taking an EMT course as an elective(if offered) while you take the usual premed classes.

I have a buddy who went the undergrad EMT route, and he used to ride along with me all the time. He loved prehospital medicine and EMS. He was always premed and knew he wanted his MD, only worked as an ER tech while in med school(never on the street) and he's now a surgeon, a partner in a physician group, making BIG bucks with 2 homes, a plane, and all the toys he can handle. That route worked well for him. He initially wanted to be a trauma surgeon but decided he wanted a "normal" life.

He still tells a great story about when I taught him how to intubate. He says he now much prefers to have someone else intubate- when they are paralyzed, dry, and an empty belly. LOL

[spenac]

when they are paralyzed, dry, and an empty belly. LOL

Yup maybe we should start doing that in the field. Sorry buddy I can't protect your airway because you ate today.

When doing intubation's at the hospital they actually canceled a surgery because the person chewed a little tobacco that morning, said the juices could have entered his belly and be a possible aspiration threat prior to intubation. They should be with me in the field where we remove the tobacco from the patient just so we can try and see the landmarks to intubate. Doctors are so spoiled.

[HERBIE1]

Yup maybe we should start doing that in the field. Sorry buddy I can't protect your airway because you ate today.

When doing intubation's at the hospital they actually canceled a surgery because the person chewed a little tobacco that morning, said the juices could have entered his belly and be a possible aspiration threat prior to intubation. They should be with me in the field where we remove the tobacco from the patient just so we can try and see the landmarks to intubate. Doctors are so spoiled.

Cancelled a surgery because of tobacco juice?? Obviously that was an elective surgery, but still...

I'll never forget my first intubation, right out of school. I kept thinking- hey, this doesn't look anything like those patients in the OR!

[spenac]

Cancelled a surgery because of tobacco juice?? Obviously that was an elective surgery, but still...

I'll never forget my first intubation, right out of school. I kept thinking- hey, this doesn't look anything like those patients in the OR!

Definitly not for a life threatening injury or illness, don't recall what it was but the guy was pissed.

Nothing like the blood and vomit to darken the way. What I hate is there are now Paramedic programs that are not even requiring intubation of anything but a dummy. At least OR patients are alive even if clean so it is more like what we deal with in the field.

Edited May 26, 2009 by spenac

[emt12resq]

OK.

I have a question for you. Youy were emt-b certfied in another state and now have moved back to the state you were orginally from? DOes the state your in now even recognize your certification? Im from VA and if you get certified in a diff county you have to go and take extra classes to be able to run.

If you want to be a flight medic my best path to tell you to take is to go ahead with your nursing. A lot flight medic places require you to have some form of nursing. In nursing you will also get IV cerified. You should also get IV and EKG certified through P school.

I hope this works for ya. Welcome to EMTCITY

[VentMedic]

Cancelled a surgery because of tobacco juice?? Obviously that was an elective surgery, but still...

No, it can be just about any type of surgery where there are already expected risks. Any surgery that requires good blood flow such as flaps or grafts will definitely be cancelled as will some cardiac surgeries.

Nicotine is a potent vasoconstrictor which can reduce blood flow to the flaps or grafted areas as well as increasing the risks of an MI under stressful situations which one might consider surgery to be.

If you want to be a flight medic my best path to tell you to take is to go ahead with your nursing. A lot flight medic places require you to have some form of nursing. In nursing you will also get IV cerified. You should also get IV and EKG certified through P school.

For Flight Paramedic you need at least 2 - 3 years with a busy service and some CCT experience in a progressive system.

For Flight RN, you need at least 3 years experience with 5 preferred in high acuity ICUs of various types.

If you are a Flight Paramedic that finishes nursing school, you will still have to meet the Flight RN requirements for experience(3 -5 years) in the ICUs to take a Flight RN position.

Flight RNs can take a bridge course, challenge the Paramedic exam or do the requirements to get a nursing credential in prehospital medicine such as EMS RN, PHRN or MICN.

The Paramedic patch is not required for RNs with Flight Programs in very many states. Many of their transports with be IFT or scene calls that require a higher level of Critical Care expertise.

Edited May 26, 2009 by VentMedic

[HERBIE1]

Definitly not for a life threatening injury or illness, don't recall what it was but the guy was pissed.

Nothing like the blood and vomit to darken the way. What I hate is there are now Paramedic programs that are not even requiring intubation of anything but a dummy. At least OR patients are alive even if clean so it is more like what we deal with in the field.

It's funny, when the airway/pharynx is clear- no emesis, no funky anatomy, no dinner, blood, or teeth- it almost seems wrong, doesn't it? LOL

An intubation dummy is fine to demonstrate the steps in a simulation or a skills assessment- proper positioning of patient's head, cricoid pressure, oxygenate, bag, etc, but to not be able to intubate a real patient- to me, that's asking for trouble. It's too important of a skill not to be as prepared as possible.

[VentMedic]

Doctors are so spoiled.

However, because of some Paramedics lacking the ability to intubate or not knowing when to stop trying and use an alternative airway or just bag, we are seeing many more swollen and bloodied airways that require the big tools to come out of the closet such as the fiber optic scopes to assist with intubation in the ED. We have definitiely seen a great increase in traumatized airways over the past 5 years. Combi-Tubes have also been part of the problem as some are just not mindful of what they are doing when the ram a tube that large into the throat and inflate cuffs that can do some serious damage if in the wrong place. There are now several pieces of literature being published on this new traumatic trend. Thus, some EDs have beefed up their intubation tools. Many of these patients may require traching if the throat does not heal in 7 - 10 days or if the ETT will further irritate a throat and cords already damaged.

So it is no picnic for those of us in the ED when these botched airways come in. It definitely is not much fun for the patient who may have to adjust to a trach tube for awhile or learn a different way of communicating. The lack of education and proper training of prehospital personnel has a profound affect on the healing process if there are complications of a traumatized airway and aspiration as well as the initial complaint.

Edited May 26, 2009 by VentMedic

[HERBIE1]

However, because of some Paramedics lacking the ability to intubate or not knowing when to stop trying and use an alternative airway or just bag, we are seeing many more swollen and bloodied airways that require the big tools to come out of the closet such as the fiber optic scopes to assist with intubation in the ED. We have definitiely seen a great increase in traumatized airways over the past 5 years. Combi-Tubes have also been part of the problem as some are just not mindful of what they are doing when the ram a tube that large into the throat and inflate cuffs that can do some serious damage if in the wrong place. There is now several pieces of literature being published on this new traumatic trend. Thus, some EDs have beefed up their intubation tools. Many of these patients may require traching if the throat does not heal in 7 - 10 days or if the ETT will further irritate a throat and cords already damaged.

So it is no picnic for those of us in the ED when these botched airways come in. It definitely is not much fun for the patient who may have to adjust to a trach tube for awhile or learn a different way of communicating. The lack of education and proper training of prehospital personnel has a profound affect on the healing process if there are complications of a traumatized airway and aspiration as well as the initial complaint.

Good points. There is no shame in admitting you can't get a tube. Even ER docs occasionally ask for help from an anesthesiologist for a tough tube. Everyone has a bad day-and just like an IV- you can always ask your partner to try if you really need that tube.

If I was having a bad IV day- blowing IV's that seemed easy- I'd call them "tape tearing days"- when all you are good for is tearing tape to secure the IV for your partner. It happens- we're all human.

Proper bagging can be just as effective in oxygenating a person. Don't destroy the person's airway and make it tougher on the ER staff.