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As someone who has hired many people, written contracts and enforced non compete clauses, I can tell you that in most cases, it's simply a scare tactic. Most terminated employees simply don't have the money to fight a legal battle. There are several reasons why a non compete will be ruled null and void. Sent from my iPhone using Tapatalk. Sorry for any spelling errors.

I'd like to attend this lab. I did the advanced airway cadaver lab at ShockTrauma, but any opportunity to practice those low frequency skills is welcome! Is there an update for 2012/13? Sent from my iPhone using Tapatalk. Sorry for any spelling errors.

What, specifically, would you like to discuss? I also work in a system with multiple tube opportunities per month, plentiful OR time, including opportunities to intubate pediatric patients in the OR, Decent, if not exactly progressive, RSI protocols, and plenty of tools to get the job done. Intubation and RSI is not an issue for our service. Our first pass success rate is in the high 90s. It doesn't seem like there's much to debate. If the system trains the medics adequately, provides opportunities for frequent practice, has a robust QI process... It works well. Systems that infrequently intubate and even more infrequently use RSI will have issues. Sent from my iPhone using Tapatalk. Sorry for any spelling errors.

Single role paramedic for a non transporting, ALS only, county based third service. Also worked private ambulance, Vollie Search and Rescue, firefighter, instructor and a few other goodies. Been in EMS since '89. Sent from my iPhone using Tapatalk. Sorry for any spelling errors.

This is how I was taught how to do it during my PALS course. Also how I bolus infants.

Good luck.

Hi all... I'm looking for a good source for inexpensive safety glasses that'll take a prescription. I have a pair a now that cost me 200 bucks and make me look like a bug. I hate 'em. They look a little like this... I'd love a pair of wraparounds like this that will take prescription lenses, not an insert: Anyone have a source that they use?

Thanks for all the the responses and comments y'all. I think it was an interesting subject for us to research and write about. This was obviously an "opinion paper" so we all developed our own argument as to why we thought CISD was good or bad. Surprisingly, I was one of the few that thought the CISD process might not be such a good idea. I read most of the other papers and many in my class think CISD is just great. Oh, and I did get an A. Again, thanks for all of your help, and I think this topic this sparked a good discussion as well. For those of you who are interested in the base set of interview questions I used to prepare my paper, here they are. Thanks you for offering to help with research for my CISD position paper. These questions should be answered based upon your own experience with CISD, not what “you think your should answer should be”. There is no right or wrong, it’s about your personal experience with the CISD process. I do need your name and some demographic information for citation purposes, however any personal information will be redacted from any public display of this paper (i.e.: on the EMTcity forums) Please answer all questions to the best of your ability. If you prefer to skip a question, please answer with ‘SKIP’. Your name: Your agency and position: Years in EMS: If you have been involved in more than one CISD, please select one instance to answer the following questions. Briefly describe the event that lead to your attending a CISD: Was the CISD a mandatory event for all responders? Did all responders attend? If no, how many of the responding group did attend? How long following the event did your CISD take place? Was it held at your station or facility or at an “off site” location? Who was the CISD facilitator or leader, and what were his or her credentials? How long did the CISD event last? Without divulging any details that you feel are too personal to share, please describe the CISD process as your remember it. Immediately following the CISD, how did you feel about your involvement in the initial incident? How did you feel about the CISD process immediately following the CISD? Did you speak with your co-workers about the incident or the CISD process after the CISD? If so, what was the overall opinion of the efficacy of the CISD process? In your opinion, was the CISD a useful event? What could your department or CISD facilitator have done to improve on that instance of CISD? Have you attended multiple CISD events? If yes to above, have all CISD events been similar or very different? If different, please elaborate on the differences. Do you feel it’s more effective to take part in a formal CISD or just “talk it out” with your co-workers in an informal setting? Following the CISD did you view your co-workers differently? Were you reluctant to speak or share in a CISD due to how you may have been viewed by your co-workers? Following a critical incident, would you suggest all responders take part in a CISD? Has your involvement with a CISD changed the way you feel about your job? Again, thanks for helping with this project. If I have follow up questions to elaborate on your answers, may I send an additional email?

I was tasked with writing an opinion paper on CISD for my “Well Being of the Paramedic” course that’s part of my medic school’s curriculum. Names and locations have been redacted. Thanks to all who replied. I’d like to hear your thoughts. The line of duty death of a coworker, a tragic accident involving a child or a serious mass casualty incident are all critical events that may trigger powerful emotional responses in the parties involved. Due to the nature of the work it would seem that Fire, Rescue and EMS workers would be at the greatest risk for the development of posttraumatic stress from these incidents. Created as a peer driven stress management tool, Critical Incident Stress Debriefing (CISD) was developed to help those exposed to such incidents deal with their emotions. However, since it’s inception, the idea of critical stress management has polarized many EMS workers. The simple idea behind CISD, to prevent or limit the development of posttraumatic stress in individuals exposed to critical incidents, may in some cases exacerbate the stress these individuals experience. After interviewing several individuals that have taken part in the CISD process and recalling my own personal experience with the CISD process, I can argue that while some I spoke with did receive some emotional benefit from the CISD process, each individual’s emotional coping skills are different, and a “one size fits all” CISD counseling session for stress management may do more harm than good in the long term. In conducting interviews for research, I used a posting on the popular online EMS forum XXXXX.com to solicit responses from EMS professionals who have been in the field for longer than 5 years and had taken part in a CISD event. I received numerous responses and sent standard interview questionnaires to the individuals. I received four complete responses that met my criteria and used these questionnaires, along with specific follow up questions and telephone interviews, to frame my opinion. I exchanged email with XXXXX, a ten year EMS veteran, who is employed as flight paramedic for XXXXX. XXXX attended her first CISD in 2003 following an incident where an acoustics manufacturing plant sustained a significant explosion and fire, which injured over 40 people and killing 17 in XXXXX XXXXX. After hearing the details of the incident and how the CISD was planned for the team of emergency responders, I asked XXXXX how she felt about the CISD process as a whole. She replied, “I became frustrated during the CISD process because I felt I was pressured to give responses I hadn’t quite come to grips with yet or really had the chance to sort out for a bit myself. I’m a very private person by nature and didn’t appreciate people trying to pry emotions out of me that I wasn’t comfortable expressing to those I didn’t know, which was ultimately the reason I got up and left. I prefer to deal with a few close people I know rather than a large group. I also wasn’t comfortable with the fact it was a forced attendance.” I was surprised to find that this CISD event had a mandatory attendance requirement and XXXXX agreed, stating, “It seemed almost as if they were forcing us to relive the event when we were discussing things … We also felt we would have been better served by a more informal process with simply the offer of additional help if we needed it rather than being thrown in front of a social worker and told ‘Okay, express yourselves’”. XXXXX went on to say that following the formal, mandatory CISD, she took part in several informal gatherings with her crew members and found that in the informal setting, she was better able to evaluate her performance and actions. XXXXX said it took a long time for the memories of that incident to fade and went on to say, “I have very adverse feelings to a formal CISD as I think it actually intensifies the incident and prolongs the recovery period from it.” I also received a reply from XXXXX XXXX, an EMT-B from the XXXXX Rescue Squad in XXXX. XXX took part in his first CISD following an unsuccessful pediatric resuscitation. In direct contrast to XXX’s experience, when asked about his experience and why he attended, XXX said, “It was definitely non-mandatory. All of the personnel were invited. I went simply because I felt slightly disturbed by how the family thanked me after I was unable to revive their loved one. I didn’t feel that I should’ve been thanked.” I then asked how he felt about the call and it’s outcome following the CISD event. XXX replied, “I felt more validated and eased in my mind about how I did things.” Even though XXX received some positive feedback and appreciated the opportunity to talk about his feelings following the incident, he was reluctant to recommend the CISD process to other EMS workers, stating, “…simply because what works for me won’t work for everyone else.” As for my own experience with Critical Incident Stress management, I took part in my first CISD in 1990, following an MVA with multiple fatalities in my hometown in XXXXX. I was the first EMT on the scene and was assigned to triage. It was immediately obvious that two of the patients were DOA and several others would require lengthy extrication. Making this chaotic scene even more emotional was the fact that several of the victims were young adults I knew from High School. The day following the incident, we were all invited to a CISD workshop at the Firehouse. I attended, not because I was having difficulty in dealing with the emotional aftermath, instead I was goaded into attending by the repeated urging of my Chief. During the CISD, I recall being repulsed by several of the other firefighters in my department referring to the trapped occupants as “hamburger” and “DRT” (Dead Right There). The braggadocio and swagger that was on display from my fellow EMS workers upset me more than the actual event. I didn’t say much during the entire event. I recall sitting on my cold metal folding chair, sipping cold coffee from a Styrofoam cup, listening to each member of my crew speak, knowing that it was important for me to listen and my just being there was helping to support the crew. I later spoke with the CISD facilitator about how I was feeling about my crewmembers and he explained that often people covered their shock and emotions with bravado, and that if I had problems I should talk to him. I never did talk to the CISD facilitator again and I continued working in EMS for several years following that incident. After the experience I had, watching my crew, I doubt I would attend a CISD event again. I’d much rather talk it out with my partner, a close friend in EMS or my priest. As EMS professionals, we will be exposed to critical incidents as a matter of course and it is clear that dealing with Critical Incident Stress is an important part of maintaining the health and well being of the EMS worker. However, I believe that a formal Critical Incident Stress Debriefing, no matter how innocuous or well meaning the intent, may force individuals to attempt to cope with these stressors before they are emotionally ready and willing to face their coworkers. Instead, I feel that department leaders and EMS management should adopt a flexible strategy to deal with traumatic stress situations. A more fluid, less structured and rigid plan, based on the needs of each individual, consisting of informal chats, the freedom to take personal time or the offer of mental health professionals or counselors could be the next step in replacing a regimented, formal, and in some cases mandatory, Critical Incident Stress Debriefing following a traumatic event.

I worked for Ron as an EMT at AASI in the late 80's. Amazing sparkling clean ambulances, tremendously ugly uniforms and many great friends I still have today. Sad too see Ron is gone.

Croaker is absolutely right with his take on King County Paramedics. Since I live in Seattle, I can provide a little more info on this system. As Croaker mentioned, Fire is the first tier in any aid response in King County, Seattle or otherwise. A medic unit is dispatched automatically to any call that presents as an ALS indicator to the dispatcher. If the BLS fire crew arrives on scene and decides that medics are not warranted, they are "code greened", that is canceled while en route. A dangerous idea? Well, that depends if you believe every patient deserves an ALS evaluation. In addition, ALL of the ALS in King County, with the exception of King County Medic One (Serving South King) is staffed by firefighter/medics. It is true that there are no ALS engines in King County, but almost all of the medic units are fire units. And there is talk of KCM1 being folded into a fire department with the potential formation of a new Regional Fire Authority. This RFA would include most of the communities served by KCM1. If you are hired as a Seattle Firefighter with the hope and intent of working as a medic in Seattle, there is a 3 year waiting period before you can apply to the medic program. Several of the medics that are working for KCM1 originally took the medic class I'm currently enrolled in. (Tacoma Community College) After completing the program and subsequent hiring by KCM1, they were required to take an additional year of intense medic school at Harborview. So, even if you've been a medic for 10 years, you're still going to Harborview for another year. However, two friends that completed that program tell me it was an AWESOME education and anything else pales by comparison. Contrary to popular belief, KCM1 does train paramedics and you don't have to be a firefighter. You must have 3 years of EMT-B experience and pass the testing and oral boards. If you make the cut, you're hired, they pay you a stipend through school and you go to work in year. They recruit once a year, the job info is here. Outside of King County there are numerous opportunities to work as a medic, most are fire based, but the usual suspects (AMR, Rural/Metro and their ilk) all hire medics. And yes, as soon as school is finished, I'm moving. FAR away from King County.