NREMT-B Test (WARNING: Mean-spiritedness inside)

[chazmedic]

I feel your pain. We have discussed for awhile about putting on a BLS transfer unit since 95% of our T-fers are BLS. However, if there is a glimmer of a possibility of a snowball's chance in the middle of July in Texas of even thinking about making the T-fer ALS so it can upgrade to ALS rates, we will have ALS trucks being dispatched to BLS transfers....what was I talking about?

[cosgrojo]

Yeah, I smell what you're stepping in for sure.

I am going to have to continue to be feisty and correct something else...Medics are good for more than just pain management and cardiac. Something like...Airway?...hrmm...and a few other things.

And I'd even bet many are familiar with BLS, too.

HA! Intermediates can intubate! once they see the ___________________ line... :shock: And don't give yourself too much credit for billing requirements.... remember who you are talking to.... hint.... *auditor* I've seen your so-called "billing" skills. :violent1:

[cdemt5710]

:headbang: Lots of interesting comments generated. I guess I'm very fortunate in my service. There doesn't seem to be alot of discussion about who's job is more effective. There's respect for everyone's level of training from 1st responder on up. The paramedics rely on the Basics and I's to get things happening in a timely fashion. Everyone understands that BLS comes before ALS. We're a volunteer service so we don't always have a medic in town and ALS providers rely on the Basics to assess well and, yes, assist with nitro, administer ASA and everything else that has already been mentioned.

Without a doubt, I would prefer good ALS if I had the chest pain. Good ALS.... oh, did I repeat that?

Do Basics know a good ALS provider from a bad one? One would hope they would eventually. I have worked with a medic who spent 10 extra minutes on scene to start 2 large bore IVs on a trauma patient (she almost lost her life due to her internal injuries). I was a fairly new basic and I knew that was not good ALS. I've worked with excellent providers and slackers. I observe all the skills they use (naturally curious) and maybe I don't know if they administered the right med at the right time (but we'll hear about ift after), but I do notice when they do other things well. Because I get to ride with 2 excellent medics, and I have seen their assessments and because they teach as they go along, all of have us have some clue about what they are doing. And I pay attention to the way a provider will clean up their rig. If they're sloppy about that I'm going to assume they're sloppy about everything else. Lots of hints when someone is an "iffy" provider. We also tend to go over each call discussing what was done (if ALS), why and what can be improved on. Critical to do with a low volume volunteer department.

Yup, I'm a lucky gal.

[InsomniacEMT]

I myself will be taking the registry in summer and I feel ready. Why?

We have a book for our class, but our tests come from various books/resources. Its not about picking the right answer, its the BEST.... trick questions. thats what the registry is all about.... And most of us dont ace his tests.. BUT.... They mimic the registry... so I am thankful that I have an awesome instructor. that tricks us, so that I will pass the registry..

One question that tripped me up big time on this past test was:

All of the following are true regarding bandages EXCEPT:

a. bandages should always be sterile.

b. a bandage is used to secure a dressing in place.

c. if a bandage becomes blood-soaked, you should remove it.

d. adhesive tape may be used to secure bandages.

I picked C....... But the "correct" answer was A..... gho figure. Because the bandage does not always have to be sterile. I thought you NEV ER removed the bandage>?

[Ridryder 911]

Well, you might want to learn the differences between dressing (i.e. 4 x 4's) & bandages (i.e kerlix, kling). Bandages can be removed, but not dressings, so yes you can remove the bandages to apply more dressing.

No bandages do not have to be sterile, but dressing should be since they will be covering the wound itself.

Be safe,

R/R 911

[TechMedic05]

"*auditor* I've seen your so-called "billing" skills."

Oh, that's right. In an effort to save more money, the company will pay you your overtime rate to avoid paying an true honest biller/ auditor. GOGO EMS!

And as far as my billing skills go...well, what ever do you mean, kind sir?

I can spell, I'm honest, and I know what the words I write on my reports mean...And! I get signatures.

What else is there? I feel I'm rather thorough when it comes to sufficient documentation. I guess if it means anything, nothing has ever bounced.

[cosgrojo]

I guess if it means anything, nothing has ever bounced.

No... that doesn't mean anything.... Sometimes.... we "fix" things that we know to be true. I.E. demographics, mileages, times (CAD), and a myriad of other things that road crews sometimes forget...... Yes... even you. :roll: And yes, I've fixed my own paperwork too.... :oops:

And yes... somewhere out there is a nomadic auditor, out of work because an EMT took their one opportunity to put their lifes passion to the test.... :-({|=

[TechMedic05]

Then how on Earth am i to ever know I was wrong, and go and correct my mistakes?

Yeah, I'm sure there's BATT charts on my paperwork, and memos, and near apocalyptic events daily, but why can't we/ you just tell people what they're doing wrong so they can fix it?

And I do find it rather difficult that an intelligent gentleman such as yourself would need to work and slave in an ambulance for several years just to get the wondrous opportunity to audit EMS run forms for billing.

I guess, to defend your company...It's only one of the largest EMS providers in the United States...not like they can afford such things.

[cosgrojo]

Then how on Earth am i to ever know I was wrong, and go and correct my mistakes?

Yeah, I'm sure there's BATT charts on my paperwork, and memos, and near apocalyptic events daily, but why can't we/ you just tell people what they're doing wrong so they can fix it?

And I do find it rather difficult that an intelligent gentleman such as yourself would need to work and slave in an ambulance for several years just to get the wondrous opportunity to audit EMS run forms for billing.

I guess, to defend your company...It's only one of the largest EMS providers in the United States...not like they can afford such things.

If I told every person every single thing that they messed up, I would be on the phone all day trying to get a hold of people. If certain issues become a trend, then we will talk to them to make sure they understand what is going on. For the most part though, they are one time mistakes that were accidently glossed over. I'm not going to gig someone that I know normally does good paperwork because they didn't write a clear time. I know how it works on the road, sometimes get's very busy, and you get paperwork piling up on top of other paperwork.

Remember... I'm still slaving away on an Ambulance.... I audit forms because they asked me to, and they pay me to do it. If you were engaged and trying to save for a wedding and a house, and your fiance was without a job because she is student teaching, and your company offers to pay you your overtime wage to stare at paperwork.... what would you do? Probably stare at paperwork.... :wink: And hey.. it's better than selling igloo's in Alaska....

[Nate]

If I told every person every single thing that they messed up, I would be on the phone all day trying to get a hold of people.

We get paged, if you develop a trend of not fixing your mistakes here you get pulled in and not paid to fix your reports (you've had a chance to do it on company time). If you don't show up, bam your gone...end of story.

If certain issues become a trend, then we will talk to them to make sure they understand what is going on. For the most part though, they are one time mistakes that were accidently glossed over. I'm not going to gig someone that I know normally does good paperwork because they didn't write a clear time. I know how it works on the road, sometimes get's very busy, and you get paperwork piling up on top of other paperwork.

It is part of being a responsible medic. Whether it is a set of vitals or a clear time, it is my responsibility to complete my run ticket.

Remember... I'm still slaving away on an Ambulance.... I audit forms because they asked me to, and they pay me to do it. If you were engaged and trying to save for a wedding and a house, and your fiance was without a job because she is student teaching, and your company offers to pay you your overtime wage to stare at paperwork.... what would you do? Probably stare at paperwork.... :wink: And hey.. it's better than selling igloo's in Alaska....

We pay people to do this job, however they only do this job. Our QA team is very good at catching mistakes, finding trends that need to be corrected with some people through additional training, and making sure we change our run tickets up as new rules/regulations come down the pipes from the local, state, and federal authorities. Your going to have to pay me more then over time to read run tickets.