MetalMedic

Thanks for the advice. I checked the RN scope of practice, the DEA and found some basic information on the site we both located. I also left a message for the state medical board. Turns out what I'm looking for doesn't really exist in the form I was looking for. But I was able to point out based on DEA regulations and Scope of Practice for RN's that they are not able to authorize meds for those reasons. In CT: Esentially Nurses are allowed to administer medications, and by providing information to "go ahead" over a med patch it would be a perscription as their orders and protocols are not the same as ours. State protocols do allow doctors to deligate authority with in scope of practice. Also, in CT nurses do not have any authority in the pre-hospital setting. Whew. Lot of research to get to that point, but it was a good question and a great class discussion. And thankfully, even though I didn't have direction information I was able to have enough resources to back up the information to my lawyer instructor. Thanks for the help! Aside note: Even though Paramedics have our own licenses (well not me yet) we are an extension of the MD, DO license. = Medical Control

Yeah I've checked on that site, but nothing specific about a MD/DO not being able to delagate to RN for med patches. Even though it's a med license we work under, some RN's are allowed to precribe meds and we are all allied health. So I'm just trying to find something in writing that has a clear line. The public health website states that a MD/DO can delagate to properly trained and certified individuals. So that doesn't really help narrow it down, but thanks!

Hey everyone! Long time no post! I've been busy, unfortunatley, I lost my paid job in May, but it "forced" me into Paramedic school. I'm still currently on the volley side and am still looking for paid gigs. Anyway... Our instructor asked us to research a few things for class on Monday and I am struggling to find where to look. The topic we covered on Monday was in regards to Med Control and all things surrounding it. We have been asked to find out if a MD or DO can delegate orders to another and if that person can carry them out. For example, as Paramedics we are allowed to use up to 10mg of drug X. The nurses are allowed to give up to 12mg of drug X. If the nurse responds to the patch, can they authorize us the extra 2mg? Most of the class said no, but on top of being a Paramedic, our instructor is also a full time lawyer, so he wants proof to back it up, not just "Well that's what we were told." I'm not having any luck from searching google for patches as all I come up with are patches for clothing. I've already checked our regional protocols and all I find is information on procedures for patient care and drug reference guides. Does anyone else have any suggestions on where to look? I currently live in Connecticut, so I know that other states may have different protocols on who can respond to med patches. Much appreciated! -MetalMedic

I just re-read what I wrote and realized it didn't come off the way I intended it. 99% of the time I refer to myself as an EMT, but on scene don't always correct people when reffering to me as a "medic" as I usually have other things on my mind. When I have people beg me for drugs for "pain" in the back of the ambulance I explain that I don't have the ablity to do so. A lot of people don't know what EMT's are, so I usually explain that I'm a Medic (not paramedic) which usually clarifies it for a lot of people. It seems that there is a general misconception among the general population that EMT's and Paramedics are one in the same. Anyway I hope that my first statement was clear that I don't ever misrepresent myself, but based on what is happening on scene I don't/can't always take the time to clarify the differences, especially when all my uniforms clearly show my level as EMT-B. -MetalMedic

My first car was a light blue 1985 Chry New Yorker "The Beast". I loved that car, it was like driving a couch. Second car: 1994 Ford Escort Station Wagon AKA "The Band Wagon" put 600K on it before I put it down. 3rd car: 1996 Ford Tarus, "The Death Trap" yeah, that was a total POS 4th Car: 1985 Chry Lebaron Convertable, "Biddy White" Still take her out over the summer. 5th Car: 1998 Ford Escort Station wagon, "Solyent Green" or as my coworkers call it, "The psycho Grocery getter" as it's got a huge skeleton sticker in the back seat so it looks like I have a passenger.

-Responded to a call for a scratch on the toe due to a cat claw. No blood. Yes, we transported. -Call to a person who is SOB. FD Medic downgrades and reports PT is a smoker. I ask PT what is going on. PT reports: "I smoke too much." Story comes out that PT has been up for 3 hours, had smoked 3+ packs of cigarettes and held the smoke too long (like with weed) and had smoked weed. Triage's response, "Tell the moron to quit smoking."

I work both a Volley and Paid Service as well as assist in teaching new EMS students. I love both services as they are two different animals. The volley service we are both R1 and R5 so we control the scene over the FD when it comes to PT care. We also have a Paramedic that comes from the hospital when needed (most of the time dispatched at the same time we are). It's nice to be able to go in and take over the scene and be able to have the story in full from start to finish. I usually do about 24 hours a month +/- and started that once I was certified. The paid service has two primary towns we work in where in the FD's have control of the scene and usually have paramedics at scene pta- generally we are transport unit, unless the call is downgraded. In the paid service it's kind of nice to have someone else control the scene and give report to us if it's downgraded. Most of the time we don't have to worry about calling a paramedic as they are already on scene. We also get to do "cool" calls such as Air Ambulance transport assists, picking up PT's from the airport with TacAir, riding with the Childrens Hospital Teams, etc. It's a wider range of calls in general. I work full time at about 48-60 hours a week. The assistant teaching is a "when ever" job and is through one of the Level 1 Trauma Hospitals here in the state. Normally I teach about 2-4 times a month. It also offers other opportunities such as assisting with NREMT practical exams and standby's for Marathons and other planned MCI's. Over all I enjoy EMS more than any other job I've had. There are pro's and con's with working with each type of service. It's just a matter of finding if you prefer one over the other or if you like doing both. And the above poster is correct, if you find yourself getting burnt out, take a break from the part time job. A lot of the people I work with at the paid service also ride on the FD's in our primary service areas. I find that there is a lot of people who work several paid/volunteer non-commerical services in EMS as well as one paid service because they are so different... and it's a good way to keep up your skills and to keep yourself on your toes. Does that help at all? -MetalMedic

I had a patient bring this up over the weekend. It was a routine transfer and as soon as they were in the back they asked, "Did you hear about the guy that fondled the girl in the back of the ambulance?" I was so embarassed. I replied, "That person did not or has never worked for this company. I don't like to talk about it because it makes all of us who work in an ambulance look unprofessional and that's not the way I like to start my rides. So, how are you feeling today?"

An example of what happened to me last week: ** Disclaimer I know that CNA and RN's are different Get a call for chest pain. I arrive and identify myself. Found a 80-90 year old pt on the floor of adult child's home. Pt is surrounded by grandchildren and adult child is taking BP. Adult child identifies themself as a CNA and explains they are unable to get a BP. Past history of heart issues. I notice pt is slightly gray and incontient of urine which is not baseline. Pulse is thready. Chest pain is radiating to arm and shoulder. I want to get the pt out NOW. Dispatch called to have Paramedic intercept if they don't meet us at scene. CNA gets in my face as we're moving PT asking if PT spouse can ride and if they can ride. I explain only one rider is allowed and spouse is it as we have 3 trained personel set to be in back. We package and move the pt to the ambulance. I get in the back and the CNA is standing in front of me having gone in the side door. CNA is again informed they will NOT be riding with us and then proceeds to put up a stink. CNA had asked driver, EMR and I if they could ride and were told no by all of us. CNA intercepted Paramedic on his way into the ambulance on scene and he had told them yes. CNA finally leaves ambulance after Paramedic is informed we have 3 trained people in the back. We ride lights and sirens to the Hospital, CNA in their car tailgaiting us. We park in the ambulance only parking area, CNA follows to same area. They are too far behind us and is not able to get in the ambulance entrance and proceeds to argue with security throwing their credentials in Security's face and is almost asked to leave the hospital. Just after spouse signs paperwork, PT codes and RN runs out of the room asking for a crash cart. What the CNA didn't understand is what we do in the field is so different from what goes on in the hospital. The CNA's actions hindered the care of their parent. Instead of stepping back and letting us do what we needed to do, they threw a fit because they wanted to ride along. Now I know that some of it was situational, but if we as EMS walk in and say, "We need to go now." It's a serious issue. I've spent time shadowing ED RN's and it really made me open my eyes as to what goes on from their end, but I don't know many RN's who will sit in the back of the ambulance for a day and see it from our perspective. I feel that RN's assume that we can or should diagnose conditions. Yes a broken ankle is pretty obvious, but we just don't have a way to come in with a difinitive answer of why some medical conditions are happening... which is why they are in the hospital.

I dislike: -The politics -Jr. High Mentality -SNF Staff not having a clue and treating us like we're being a pain when we ask for certian information -One hospitals Reg staff who throw a fit when we bring in patients and give us wrong demo sheets -No where to pee after 9 pm in certian posting locations -Patients who feel entitled to something, especially the entitled bariatrics family memebers -Patients to treat us like a taxi service I love: -Knowing I made a difference -Most of the people I work and volunteer with -Most of my transfer pt's -The Fire Department Medics and EMT's -The hours -The pay -The uniforms (save so much time in the am) -Patients families who call or write my super with positive reviews (see first in Likes) -Dealing with children -Getting to pick up special riders (Air Ambulance Team, Doctors)

Geeze, I didn't realize that some people would be so up in arms that I want to make sure I keep my BLS skills sharp when I start working ALS. Just out of curiosity, are all those offended/ those who posted Paramedics? I agree there are times when ALS can help before doing BLS... But if you gave meds before doing the ABC's then perhaps you've shown the point I was trying to make. It's our state protocol. The majority of the local town volunteer companies are only allowed to do BLS skills. We have Hospital Medics that are called on scene as back up if needed. If they aren't available, the local private companies intercept. Just had one not too long ago where my FTO at the private company intercepted with my volly service with me on board. Made patient care go a lot more smoothly. I know there is some push back by locals to have that changed into possibly having paramedics join services and ride along... but most of it is politics right now. I haven't started my paramedic program yet. I'm getting road time and making sure that I'm the best EMT that I can be and 100% comfortable with that before I start. But I digress, who knew that working at both an EMT and a Paramedic would cause so much hostility... I thought that working both would perhaps close the rift between the two. Guess not. Thanks everyone for the food suggestions! Making myself a nice sandwich for the long week tomorrow.

I knew the comment would get a few raised eyebrows either way. To clarify: All Paramedics should have BLS skills done as well, but I know that I could potentially fall into habit of going straight to ALS after ABC's. It's not meant as a dig, but a personal preference to keep my skills in good practice and good check and so I have a clear line of what is ALS and BLS as I have a feeling that they could possibly become blurred when I first start. Then again, I'm not a paramedic yet. The few paramedics that work on the BLS only with me have stated it's a good way to make sure they don't lose sight of their BLS skills (beyond ABC) or practice. I also know that a handful of paramedics have god like complexes (I've worked with a few), so it's a way to keep me humble and grounded. I don't think I'm setting myself up to be a bad paramedic by showing I want to routinely have first patient contact and not being able to rely on machines to tell me what I should already know or to rely on meds as a first resort. So essentially, I'm taking all of the bad paramedics practices I've seen and vowing to do the opposite. DISCLAIMER: NOT ALL PARAMEDICS DO THIS. Does that clarify? And thanks for all the awesome food tips! Should I throw a monkey wrench and see what vegetarian road foods anyone has taken? Finally off to get my first real meal of the day after 14 hours... Crazy shift!

In my area there are about 5 hospitals we go to on a daily basis, and about 3-4 others outside that area depending on where we are posted. Some of them have microwaves in the EMS rooms, but not all of them and it's a little hard to tell when we'll have access to them. I keep a bag of nuts and trail mix in my bag, which is always an awesome idea! Thanks for the tips. Keep 'em coming!

Not too long ago I was assisting a new EMR doing a truck check. We always keep the radio on so we can hear if we are possibly going to be sent for a mutual aid call. We heard a call come in for an 80+ person with AMS and a history of dementia. The town called responded and we continued on. Shortly after we hear a tone asking for the air ambulance to meet them at the hospital do a transport. The EMR wondered why in the world the helicopter would pick up an AMS. I explained even though there is a history of dementia it could be AMS due to a head injury, there could be massive blood loss from the injury, subdural hematoma, etc. (As we all know that what we get called to and what we find are usually vastly different). We keep working on the checks and he's listening intently on the progression of the call. We don't always hear the med patches as they are on different radio systems/channels, but about 5 minutes later we hear the air ambulance touch base with dispatch and confirm they are going to pick up an AAA. It kind of threw both of us for a loop, but it was a really good teaching moment, especially for someone who's even more green than I am. Just a little reminder to always prepare, but never assume.

Hey everyone! I know it's been a while, no excuses! I'm still at the Volly Service which I am still loving, but also just got hired for a private company as well! I'm beyond thrilled! (Since I know this will come up, I plan on staying at the Volly service too. The reason is the Volly is only BLS and when I become a paramedic, it will be a great way to keep up on my BLS skills.) Anyway, I've come to realize if I bought lunch and dinner every day I'd be spending a lot of money. I know sandwiches can and will get old fast so I'm wondering what everyone else takes for lunch/dinner. I can't really do a lot of leftovers or reheats as I don't know if I'll be guaranteed to have access to a microwave that day. So what are your favorite on the road meals?