critical care work for new medic

[anthony02]

Hi everyone,

I have a quick question for everyone - is it possible, common, or even advisable to be hired as a hospital-based critical care medic soon after finishing medic school (say in the time it takes to achieve one's CC certification)?

Does the answer change if the job is at a pediatric hospital?

Thanks for the input.

[Jwade]

Hi everyone,

I have a quick question for everyone - is it possible, common, or even advisable to be hired as a hospital-based critical care medic soon after finishing medic school (say in the time it takes to achieve one's CC certification)?

Does the answer change if the job is at a pediatric hospital?

Thanks for the input.

Dude, I do truly hope your joking? You want to do Pediatric Critical Care Transport having JUST finished Paramedic SCHOOL?

Short Answer = ABSOLUTELY NOT!

I will tell you what, if you can tell me the pathophysiology of Tetralogy of Fallot without having to use GOOGLE, then I might be willing to listen to your argument.

I really hate to sound like an A$$ here, BUT, there is NO way on this earth, any brand new paramedic is ready to do ANY type of CC transport. That included myself back in the day.....In fact, I have tons of CC experience, education, and when I took PNCCT last year ( Pediatric Neonatal Critical Care Transport Course) ( 10 Days, 8 hours day) i only scored an 86 on the final exam........This stuff is NO joke, and will truly be beyond the mental capacity of 99% new paramedics. So, Unless you are the statistical outlier, the answer is NO.....

I suggest, go work the streets for 3 years, start taking CC courses, PNCCT, read some ICU nursing books, do ride alongs with a CC crew. Send me a PM, I can point you in the right direction for books and classes to get you started.

There is an old saying, You don't know, what you don't know, ( Until it is too late)!

Respectfullly,

JW

[VentMedic]

You might get hired as a Paramedic right now but your title would be Driver and with no patient contact.

Why pediatrics as a new Paramedic? The Paramedic curriculum barely prepares you for pediatric emergencies for the short term to get the child to the hospital. If you really want to work with pediatrics you would have better chance for a pedi critical care team by getting your RN. Even an RN for many teams needs his/her BSN and 5 years of experience with at least 3 of those in the critical care unit. The same goes for most RRTs.

Here is a good article from the AAP which provides the guidelines for Pedi transport.

Interfacility Transport of the Critically Ill Pediatric Patient*

http://chestjournal.chestpubs.org/content/132/4/1361.full?ck=nck

Here are just a few books you might want to study. The list is from the new Neonatal Pediatric Transport exam site which is a very watered down exam.

Advanced Pediatric Emergency Care, Jenkins, James, Pearson Prentice Hall, NJ, 2007

AeroTransportation A Clinical Guide, Martin, T, Ashgate, 2006

Air & Surface Patient Transport Principles and Practice, Holleran, Renee, Mosby, St. Louis, 2003

Air and Ground Transport of Neonatal and Pediatric Patients, Woodward, et al., AAP, Illinois, 2007

Atlas of Procedures in Neonatology, MacDonald, LWW, 2007

Comprehensive Neonatal Care An Interdisciplinary Approach, Kenner et al., Saunders, Philadelphia, 2007

Core Curriculum for Neonatal Intensive Care Nursing, Verklan, Saunders, Philadelphia, 2009

Core Curriculum for Pediatric Critical Care Nursing, Slotga, AACN, Saunders, Philadlephia, 2006

Current Diagnosis & Treatment in Pediatrics, Hay, et al., McGraw Hill, NY, 2007

Egan's Fundamentals of Respiratory Care, Wilkins, et al., Mosby, St. Louis, 2009

Handbook of Neonatal Intensive Care, Merenstein, et al., Mosby, St. Louis, 2006

Infectious Diseases of the Fetus and Newborn, Remington & Klein, Elsevier Saunders, Philadelphia, 2006

Kendigs Disorders of the Respiratory Tract in Children, Chernick, Saunders Elsevier, Philadelphia, 2006

Manual of Neonatal Care, Cloherty, LWW, 2007

Maternal, Fetal & Neonatal Physiology, Blackburn, Susan, Saunders, Philadelphia, 2007.

Mosbys Paramedic Textbook, Saunders, Micki, Mosby, St. Louis, 2007

Nelson Essentials of Pediatrics, Kliegman, et al., Elsevier, Phildelphia, 2006

Neonatal and Pediatric Pharmacology Therapeutic Principles in Practice, Yaffe, LWW, 2005

Neonatal Perinatal Medicine, Martin, Elsevier Saunders, Philadelphia, 2005

Neonatal Resusictation Textbook, AHA, AAP, 2006

Neurology of the Newborn, Volpe, Saunders Elsevier, Philadelphia, 2008

PALS, Aehlert, Barbara, Mosby, St. Louis, 2007

Pediatric Cardiology for Practitioner, Park, Myung, Mosby, St. Louis, 2008

Pediatric Dosage Handbook, Taketomo, Lexi-Comp, 2008

Pediatric Education for Prehospital Professionals, Dieckmann, Ronald, AAP, 2008

Pediatric Emergency Medicine, Baren, et al, Saunders, Philadelphia, 2008

Pediatric Trauma Pathophysiology, Diagnosis and Treatment, Wesson, David, Taylor and Francis, NY, 2006

Red Book, 2006 Report of the Committee on Infectious Diseases, AAP, Illinois, 2006

Robertsons Textbook of Neonatology, Rennie, Elsevier, 2005

Textbook of Pediatric Care, McInerny, AAP, Illinois, 2009

Textbook of Pediatric Emergency Procedures, King, et al. LWW, 2008

Journals

Advances in Neonatal Care

Air Medical Journal

Clinics in Perinatology

Newborn and Infant Nursing Reviews

Paediatrics and Child Health

Pediatric Clinics of North America

Pediatrics

Respiratory Clinics of North America

Seminars in Perinatology

The Journal of Perinatal & Neonatal Nursing

Edited October 26, 2009 by VentMedic

[FireMedic65]

That's a lot of reading to get into the field. Quite honestly, I am glad to see that. Too many people want to take the shortcuts into their jobs. Dealing with life and death, should never be taken in shortcuts.

[stcommodore]

You come out of school hardly prepared to work the streets to begin with, but apply for the jobs and see what happens.

[scott33]

Assuming your question was serious, I can't fault your enthusiasm, but I agree that you need to learn to walk before you can run.

[VentMedic]

Here are some examples of excellent dedicated pedi teams:

Arkansas Childrens (one of the best)

http://www.archildrens.org/medical_services/transport/angel_one_staff.asp

Children's Hospital of Wisconsin

http://www.chw.org/display/PPF/DocID/34487/router.asp

Cincinnati Childrens

http://www.cincinnatichildrens.org/svc/alpha/t/transport/default.htm

West Virginia University

http://www.wvukids.com/healthcare-services/ground-transport.html

UCSF Childrens

http://www.ucsfchildrenshospital.org/services/transport_service/index.html

Children's Hospital of MI

http://www.childrensdmc.org/?id=1426&sid=1

University of Michigan (one of the first to do mobile neo ECMO)

http://www.med.umich.edu/survival_flight/

U of FL, Shands

http://www.shands.org/hospitals/UF/ShandsCair/neopeds.asp

Wolfson, Jacksonville, FL

http://community.e-baptisthealth.com/services/emergency_kidskare.html

Arnold Palmer, Orlando

http://orlandohealth.com/arnoldpalmerhospital/OurMedicalSpecialties/PediatricCriticalCareTransport.aspx?pid=4943#

There are some ground teams that offer a "general" critical care transport as well as some flight services which take all patients. However, the AAP still advises hospitals to use a specialized transport team for peds and neo. There are also some states like CA that will limit what you can do as a Paramedic.

Edited October 26, 2009 by VentMedic

[chbare]

Another thought that can give you great experience is working in the ER and/or ICU as a paramedic or technician. You will gain valuable experience if you nab one of these positions.

Take care,

chbare.

[anthony02]

I appreciate the responses everyone, thank you!

[Dustdevil]

It's going to be specific to the programme. Around here, the medics on the pedi teams are pretty much just drivers and nurses bitches anyhow, so you would never be in a position to direct patient care. If such is the case, go for it. It's a great opportunity to learn. Any hospital based position would be. They keep you focused on total patient care, and not just fifteen minutes of protocol medicine.

But yeah, if we're talking about a team where they are really sending critical pedi patients out with just you and a driver, and no nurse specialist, I personally would not go or it. Not even if you crammed a "CC certification" (whatever that is) in somewhere.