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Hey Riblett, you might be better served to look to Facebook on this rather than here. this sites sort of dead now. No offense to this site but it it what it is. -
Hello EMS friends, I will be traveling to the UK and Ireland in June 2019 (next month!) and I am hoping to learn more about the EMS systems in England, Wales, Scottland, and Ireland first hand. The process of cold contacting all these agencies seems overwhelming (although I will if needed). My excitement was dashed a bit when I read on their website that London Ambulance Service does not do ride alongs. But they will allow other healthcare providers to visit with the proper paperwork. To my colleagues across the pond: Can you give me any insight into how to approach this? Do you know of any 911 agencies that would allow an international ride along? Where should I start? A bit about me. I am a paramedic of over ten years and an EMS instructor. I am also a nurse practitioner specializing in emergency medicine and a former ER nurse. I can provide all manner of background checks and letters of introduction/recommendation from my employers and faculty. Is this realistic? Can it be done? Thank you in advance. - Earlier
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Well I'm not sure how my new job will want my narrative. It's been 9 years since I wrote one and I'm getting back into the swing of things starting May 15th. But my reports when I used to write them were hand written on a paper report form. yeah, it was before computers got in our way of writing reports and before we had to tick off all those legal mumbo jumbo boxes to make the bean counters happy. So I'll give you a idea of what my narrative was like. Remember this was a long time ago so I'm sure others have better ways of doing things now. But I can tell you, my narratives never pulled me into court. 1st paragraph - What happened - why you were called, what you found, what bystanders said, what patient said, what you observed. etc patient exam/assessment - the formatting of this site makes it hard to put it all down line by line but here goes Heent(head, ears, eyes, nose, throat); Neck; Chest; Lungs; Heart; Back; Abdomen; Pelvis; Gi/GU; Extrems; Neuro/GCS/RTS/ (all of these go on their own lines with what your exam findings are) What is your Impression/Impact - what did you really decide is wrong with this patient - they say we don't diagnose but we really do. So don't be afraid to say if they are having chest pain to say chest pain or if their 12 lead shows elevation in II, III and AVF to say that. What is your impression or suspicions. And now your treatment - Number them sequentially - from when you got there to when you dropped them off at the hospital - make sure you put down if they got better or if they got worse. Don't be afraid to say that if your treatment made them worse - say it because sometimes your treatments make them worse. Sometimes your treatment like Synchronize cardioversion causes them to go into v-fib. that makes them worse. Or you give them Lidocaine to a paced rhythm (honestly I didn't see the pacer spikes- really i didnt' and you nearly code them) put that in the report. (man I felt like crap on that one - but I was a brand new medic and I learn from my mistakes and teach from those mistakes). That's all I got. Oh yeah there's one more thing - there is a very obscure book out there, if you can find it, buy it and never let it go - I did and the person lost it. It's called "The Missing Protocol-A Legally Defensible Report" by Denise Graham It doesn't tell you how to write a report but it does tell you how to write a report that will keep you out of court if you do it correctly. It's out of print so I'm not sure if you can find it, I haven't been able to find it. May the person who lost my copy be crapped upon by a thousand camels with IBS and C-diff. I hope this helped.
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So, I'm a year into being an EMT and I feel like I've at least started to settle into a narrative style that works for me. But, I'm always looking to do better. Recently, I've wondered if there are any books out there or just personal experience that could help me. The main thing I'm looking for would be sentence structure and word choice. What helps you break down your call and how do you create a story of what happened so that the person reading gets the full picture?
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NREMT TEST -Replies So needed
Just Plain Ruff replied to Shorty1213's topic in Site Announcements, Feedback and Suggestions
sorry you haven't gotten a response but this is my advice 1. do not allow him to retake the test until you speak directly with the registry. 2. Talk to them about what accomodations they can give him and what he qualifies for. 3. Ask them what kind of study guides or assistance they can offer for him to prep for the next attempt at the test. 4. DO NOT ALLOW HIM TO TAKE THE TEST AGAIN until you have done all 3 of the above. He only gets 2 more times before he has to I believe take a refresher course and you don't want him to do that. Just call the registry and talk to them. We can give you advice here but please go to the source and call them directly, they are the experts about their testing process and what accomodations that they can offer someone with a disability. That's my advice. -
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I am writing this in hope of feedback, I have a nephew that has passed the EMT class, he passed his practicals.. The problem now comes with the actual National Registry test. He has failed 4 times, the kid does legitimately have a learning disability and qualifies for special accommodations . As I am helping him fill out the papers I am not sure what to request. Other than more time maybe ? This is really heartbreaking to my family he worked so hard and knows the material, he just does not test good.. Thank You -
Shorty1213 joined the community
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Ok, heres what I purchased today from Amazon shears BONTIME Trauma Shears - Premium Quality EMT Shears, Stainless Steel Bandage Scissors for Medical, First Aid, ER, Nurse, Doctor, 7-Inch(2- Pack, boots - already have non-steel toed boots. I think I can wait a while to purchase those if ever. I never needed them when I was practicing prior to leaving so I'm hedging my bets that I won't need them now. pen light - https://www.amazon.com/gp/product/B07N1G7179/ref=ppx_yo_dt_b_asin_title_o02_s00?ie=UTF8&psc=1 Belt - going to purchase the belt when I get my pants Already have my field guide - have purchased already I think that's what a guy with a few years under his belt in the field actually needs. any other suggestions that won't make me look like a total dumbass???? One other thing, after digging through my storage boxes, I found my Littman Cardiology II stethoscope that I've had since 1992. The only thing I need to purchase is new earpieces as there is a hole in one of them The replacement earpieces will be here tomorrow.
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I want to add to my post Fentanyl is a great drug. It can be used on most anyone. I've used it from 2 year olds to 80 year olds and probably older but I can't remember. I don't remember a patient ask me personally to give them fentanyl, but remember I've been out of the field full time for 9 years, (part time for several), but I've been asked to give patients dilaupid(yeah I know it's spelled wrong) more times than I have fingers and toes. There is abuse potential in a lot of stuff we give. Hell there's abuse potential in flexeril as well, that's what a friend of mine was hooked on and what eventually killed him in an over dose when he took an entire bottle (90) pills because he was just tired of livin and wanted out. So I do not believe we should get rid of fentanyl just because it's the soup du jour of the addicts this year and last. 10 years ago, I believe diluadid was the soup du jour of addicts in my emergency room. It's what they asked for by name. Who knows what will be on the menu in 3-5 years from now. But for goodness sake, don't take a tool out of our arsenal because a small subset of the population have made it their drug of choice to abuse and kill themselves with. That would be I believe foolish and a knee jerk reaction, but then again, it's what we in america are known for, knee jerk reactions to a problem without finding a solution first.
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Yes. Fentanyl is addictive with potential for misuse. Morphine is also addictive with potential for abuse. As are the benzos we carry for seizures/sedation. Ketamine? Well, that's so blatantly addictive/misused that it has it's own street name. When used appropriately it is exceptionally effective. With what do you suggest it be replaced?
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I think you should be good. If you are looking for a stethoscope, but don’t want to purchase an expensive one. ADC & MDF make good quality ones.
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Ok, so I can make it official. I got the call with the offer. I will find out my start date Friday when I go down and pee in a cup and sign the forms for my background check. I'm clean as a whistle though so that shouldn't be a problem. Now I gotta figure out how to pay for all the gear(I'm not a noob so I won't go overboard) that I need. 2 - 3 pairs of ems pants stethoscope shears boots They provide the shirts but I have to buy them(they order them for me) pen light Belt Already have my field guide I think that's what a guy with a few years under his belt in the field actually needs. any other suggestions that won't make me look like a total dumbass????
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Yes we do have alternatives but I say keep it. A great mentor one time told me this, if a person is going to get hooked off one single EMS administration of a drug we give them, then they are probably hooked on something already.
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Cardiac Collapse + Nitro + ED Meds
Just Plain Ruff replied to stillnotcharlie's topic in Patient Care
Yes I agree that this sounds like a real situation. And yes there is a lot missing. Would like the original poster to return to give more information. If this is his loved one that would be very helpful to know. If he's searching for answers to why paramedics or emt's did this or that and this might go to court for malpractice, he's not really going to get any information from us to possibly hang those medics out to dry as that is what the court system is for and that's what the expert witnesses get paid big bucks to do. I don't expect the OP to return but I would like him/her to do so in order for us to understand more of what they are wanting us to answer. -
Jeff2019 joined the community
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Should EMS abandon the use of Fentanyl in the field? Based on the fact that it’s a highly abused and addicting substance. It’s not like we don’t have alternatives. Please share your thoughts.
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Unfortunately there is no way to answer your question without having additional patient information. Including the patient’s Allergies? Medications? Past Medical History? Events prior to the emergency. In all honesty this sounds like a real situation.
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Ruff, You will do great! Go show the kids how it’s done! All the best
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Oh my goodness Mike, you hit the nail on the head. There have been more jobs lost, more marriages ruined, more relationships destroyed and more homes ruined by facebook than any other electronic medium every before. I personally know of at least 20 couples who have divorced because of facebook. I personally know of 30 people who have lost their jobs due to inappropriate facebook postings. I have multiple friends at work, church, and outside church who's children have sent Dickpics/naked pics to their girlfriends/boyfriends that have then gone viral over other media and it has ruined their childrens lives. I actually counsel and do small group lectures/sessions around my area on how to address it when this does happen to your family. Facebook is not the only culpret. There are other social media sites that are just as bad, some are even worse, some MUCH MUCH MUCH worse. I am putting together a teaching slideshow that I will be using with my small groups and hopefully be able to get this citywide/statewide someday. If I can get a non-profit put together and a sponsor group to back me I would love to take it nationwide because I feel so strongly about it. Guys/gals - I have 2 daughters 7 and 9 years old, and a 16 year old son. it's out there and ready and waiting for them. My son is a good kid, he's already been hit with some of the garbage that is out there. I weep for those who have been hit harder than we have. I set up my son's facebook account when he hit age 14. It has all the privacy filters and such. I have his password, I am his friend on facebook, his mother is his friend on facebook. We see every post he posts, he posts maybe 1-2 times every week. he knows the risks and dangers but he still got caught up in the cesspool of the other dangerous social media sites. I won't go into it here. It was not as bad as it could have been and we got through it. I have Police officer friends who work in Kansas City's Sex trafficking undercover world and I've been on their raids, and I watched them arrest a shit bag who was getting ready to have sex with a 3 year old. I cried my eyes out for 2 days. But she is safe and in foster care. I wanted to kill the guy and so did the officers but he is spending the rest of his life amongst the worst of the worst. It's awful and terrible. These are the officers that I've worked with to build some of my material. I've also worked with officers who work cyber crimes and crimes against minors division. it's out there, and our job to keep our kids safe. Sorry that this got off the rails but it's on us to keep our families safe, especially our daughters. and our son's. More to come
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I've been saying it for years but people are only now, slowly, beginning to realize it. Facebook is the devil.
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I've been here for many years. I've seen it when we had dozens of new posts a day, the chat room was jumpin and we had active members who checked this site on a daily basis. Now, it's lucky to see a new post once every two to three weeks. I still check this site about every 3-5 days or whenever the site decides to notify me of a new post which is hit or miss. Honestly I do not believe this site is relevant to a new provider as there just are not enough active members here to be a good site to come to. Can that change - yes I believe it could but there are so many facebook groups that honestly are just as good as we Used to be. We used to be the site of choice prior to Facebook becoming the place to be. Now Facebook is the place and with Facebook's instant responsiveness, this site unfortunately cannot hold a candle to Facebook. Good discussion can be had here but there has to be people to discuss things with and I don't see that here. There was a time a couple of months back that I wrote a post pointing out we had X number of members but in a period of X number of months there were only 2 new posts and a small number of replies to existing posts. I was needless to say Dismayed but it is what it is. I'd love for this site to return to it's prominence it once had but I fear that it is never to be again. Maybe but maybe not. Who knows, maybe someone else has a different take. EMT City, Dinosaur still holding on? Prove me wrong!!!
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Years ago I found this site as a brand new provider. It helped shape where I am now and put me in touch with mentors I am forever indebted to. Site activity has been quite low for some time now so It's difficult to say if it would serve a new provider the same as it did me.
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Yeah, I'm taking a video refresher course by Jon Puryear - learning a lot - I guess that's why they call it a refresher right. Just took ACLS last week - learned some good stuff Taking PHTLS wed and thusday of this week PALS soon Start date would be May 15th as that's the next orientation date. I should be all certed up by then. It also gives me time to keep working my part time consulting project and get some money to buy my EMS Gear that I'm going to need. nervous but ready.
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I'm going with a probable welcome back to the field. Sometimes it's nice when what's old is new again. I spend most of my time flying now but still enjoy the occasional shift working a street car. I like the reminder as to where I came from and why I decided to move into my current area of practice.
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EMT program University of Alberta - Augustana Faculty
Just Plain Ruff replied to PayneLess's topic in General EMS Discussion
I had to respond, I think it's a record in thread resurrections. And Shitty advice to begin with from the original Necromancer. -
EMT program University of Alberta - Augustana Faculty
rock_shoes replied to PayneLess's topic in General EMS Discussion
Wow. 11 year old thread resurrection. Impressive!
