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  1. Earlier
  2. So many familiar faces - so many great friends from long ago. many have come and gone. many have gone forever - gone to the EMS systems in the sky. Good to see you all come back to say hello.
  3. Anyone in here use the Ram Promaster type II van ambulances? I'm curious how well they hold up, how medics like them compared to other makes.
  4. Welcome back everyone! Good to see you guys on here...
  5. Crazy world... this reply just showed up in my inbox. How is everyone holding up?
  6. Damn Kiwi. The force is strong with you. I just happened to be sitting here bored and for some reason, this site popped into my head and I figured I would check it out. What are the chances that you were here less than 2 weeks ago and then Fire and now me? Are you going to summon Dust back from the grave next? Glad to hear things are going well for you.
  7. Kiwi, I like you wandered back into the forums after a few years hiatus myself. Happened to get a random junk email from EMTCity about a post I might be interested in and here I am looking through forums and reminiscing on my old, posts as a paramedic student and new paramedic. The nostalgia is real my friend.
  8. So, I am a paramedic program director (have been for a couple years now) Some of you who remember me from few years back will know I started out in the fire service, got my paramedic, and did rural EMS before landing into EMS education. I just want to make it clear I didn't go directly into education without paying my dues in field time. I think this is a bad move for NREMT. It adds a loss of trust to hold EMS certifications in a higher standing as well as a loss of trust that they are acting in good faith. Let me explain why. If you look at most any other healthcare profession, whether that be nursing, PA, NP, respiratory therapy, radiology technician, etc. They are all accredited programs and you have to be accredited by their one or multiple accreditors before you are even thought about being allowed to test. Accreditation means that you get reviewed every so many years (CoAEMSP which is the EMS accreditor through CAAHEP, does their reviews every 5 years with annual reporting every year). This site visit and comprehensive review makes sure that you are holding to the minimum standard expected by CAAHEP and if you aren't, what you need to do to get yourself straightened out. CoAEMSP luckily is not a hard-ass committee on accreditation that wants to immediately punish you and revoke your stuff because you missed something, but they act in good faith that they will inform you of your missing areas and give you time to get it straightened out and assist you in doing so if you ask. The current NREMT requirement of CAAHEP accreditation makes sure that all paramedic programs are at least meeting those standards. One of the biggest standards is that the programs are held accountable to what they require of students as well as mandating that programs do continuous internal reviews of their programs to improve them every time. This is hugely beneficial for programs in general but also improves our education and end level competency for our paramedics who are entering the field to start filling holes set forth. How can this be seen as acting in bad faith? I see it as an act of bad faith because it makes all the work and stress of programs who had to meet and maintain the CAAHEP accreditation requirements and the money and time spent to do it a waste. Accreditation is expensive, especially initially getting accredited, whether that is going through CAAHEP programmatic accreditation or starting with institutional accreditation and then getting programmatic. It is also a huge time investment for the programs. Especially when you look at program directors. We see about a quarter of program directors leave the position each year in paramedic programs, a lot of the time due to the stress and hell that the job can be from time to time. Also, I don't think we do a great job prepping our program directors to transition well from EMS providers to program directors, but that is a different Ted Talk. NREMT made this requirement with a hard deadline all programs must meet (again some just needing to get programmatic accreditation while some had to get institutional accreditation then programmatic accreditation as you cannot get programmatic accreditation without institutional). This was done with the expectation, belief, and faith that NREMT would not back down from this requirement and it would hold true to that mandate. They started this requirement to mandate full CAAHEP accreditation or letter of review (meaning in process of gaining programmatic accreditation) as of January 1, 2013. We are now less than 10 years or two site visit cycles away from that decision and suddenly they have decided to back away from that mandate. It is hard to demand our profession be respected, paid better, and recognized as the profession we should be when our own certification agency is willing to drop standards and burn all the programs that have been working to obtain, meet, and maintain these standards. I hate the comparison of EMS to nursing as its apples and oranges, but EMS and NREMT need to pull their head out of their asses and keep the accreditation requirements they have adopted just as all other healthcare professions have before us. Once you go back to "state approved", its hard to say what standards those students are being held to cause there may not be a third-party double checking them.
  9. Eric

    Kiwi

    Glade your doing well
  10. Hi all Gosh, how funny to be back here after nearly ten years absent. I was researching something for work and it led me onto a report about the ambulance service, which reminded me about how all those years ago (now) that I used to make posts here and how, at that tie, being something quite new and interesting to me, I became a little, well .... hyperinterested .... in it. Ahahaha, I laugh at how much of a wanker I probably made of myself and how long ago that was. I think it was the year I first went to work at summer camp which included a medical first responder course. Maybe it was the year after, I can't remember. Anyway .... I eventually did get on with my medical degree. I was then sitting in the medical library one day and it hit me I didn't really want to be a junior doctor studying and working horrid hours and such into my 40s. I wanted to be an emergency physician or intensivist so no private practice, all in the pubic system, so the nights, weekends, etc are a part of life. I thought bugger this. The uni said I could do nursing or pharmacy instead. My friend is a pharmacist and he is like stay away mate. So I have, and I'm glad I did. So instead, I became a barrister* specialising in defence and various other bits and pieces, including our statutory accident compensation scheme, good bit of medical stuff involved there so super interesting plus I can understand most of the terms. It's basically the same as being a doc; see, diagnose, treat. Just no first-hand blood involved. It's not bad and I'm happy enough. I did go on a nice date with a House Officer not long ago. The irony is not lost on me. She wants to seme again so that's good I reckon. Well, good one, thought some of you would chuckle at this. It's also good for a bit of the nostalgia, which I'm getting a bit all about now that 40 is closer and closer. Take care all Kiwi * We have a fused profession so unlike in England where one is either a barrister or a solicitor, I am both but I tend to take work from outside referrals which more closely resembles a barrister. I'll be applying to be a barrister sole probably at the end of the year.
  11. You will not get an email notifying you of this - the unfortunate thing is that they don't notify any of us of anything like this, we have to be proactive and read up on this on our own. I'm against this - plain and simple. The new emt's and medics that are coming out of school and getting licenced are a hodge podge of quality over quantity. I had a brand new EMT get hired at my agency. She had no idea how to put a regulator on a oxygen bottle. She didn't know really what the heck a Long spine board was or what it might or might not have been used for. Traction splint - yeah that is a long metal splint that you use if you have time. These people are being taught to the test and the test only. Ask em to think critically and they fall apart. I'm not saying they all do this but the majority of those I've seen are ill prepared to face a critical situation until they are hired and have a strong preceptor to hold their hand and tell em what to do. They rely on just enough to get by. If we allow this change to happen and it WILL happen if not enough of us step up and make our voices heard, people are going to suffer and they will die. Not to be a doom sayer and negative nelly but remember back to when you were a brand new medic. Remember how much you didn't know, now take away the degree aspect of the learning and put the licensure in the hands of an already strapped overworked state bureau of EMS to oversee dozens if not hundreds of new fresh emt's and medics taking their classes and learning and just how can an already strapped and overworked and underfunded and understaffed agency like the bureau of EMS (Yes I know you like to bash your state bureau of ems because i do to) and expect them to take on even more responsibility in overseeing all these education programs and ushering in these new undereducated students - soon to be new providers. Do you see the problems here??? This is an awful rule proposal and it's going to get your grandmother injured or killed. maybe not yours but someones.
  12. Interesting. I have registry, and I did not receive an email notifying me of any of this.
  13. Looks like the NREMT is getting pressure to allow states to approve Paramedic courses in leu of CoAEMSP. https://nremt.org/News/An-open-letter-to-the-National-EMS-Community-from Is the CoAEMSP requirement limiting the amount of new Medics? Should the states have control over the programs vs a 3rd party?
  14. Hi all! Stay safe!

  15. That sucks, may he he rest in peace!
  16. https://www.covidtests.gov Easy, free, and 100% legitimate. Be safe out there and stay healthy...
  17. ok, first off, there are about 2 regular members looking at this site and I'm one of the two. Maybe there's more but this site is pretty dead. No offense to the admin/owner here but everyonce in a while we get a new member. This is probably not the site for you to ask these types of things because you won't often get a response until 1 or two months later and I assume this is too late for you. the insulin medication is incorrect - I'm almost 100% sure that insulin is not given orally but I don't know about outside the US but I'm pretty sure. This patient needs a endocrinology consult STAT and there is much left out of the scenario to give much better answers. If her sugar was 500 or was it 900+, that makes a difference as well as if she was throwing ketones or not. I would slowly decrease her blood sugar by not more than 200 per hour. Watch for hyperkalemia She needs and ICU bed at a facility that can handle her, not a icu bed in a small hospital like some of the ones I take patients to. 4 bed ccu or icu's dont' really cut it. She needs probably a cardiac consult, gi consult, nutrition consult, wound care if she has wounds (diabetics often have unhealed wounds) etc etc etc. A facebook group I can recommend is Master Your Medic you can join, and post this question there and it will get you faster and better answers from some of the smartest minds in EMS today.
  18. Here's my jumbled thoughts. The private that I'm at now is contracted to a "World Famous Clinic." 🙄 I think that we're doing about 100-175 transfers every 24 hours for them. I'm getting 1 covid pt every shift or so. All of them have been vaccinated. A year ago, I found out that I had it. As of the beginning of last month, I still tested positive for antibodies. My employer had a mandate in place that was effective 1 Dec stating that all employees had to be vaccinated. Even if you had antibodies, you were required to have a minimum of one shot. They had exemptions, but the last that I had heard, almost none of them were accepted. Due to the injunction that was signed, I went to work on the first. For how long, I don't know. Now, the technology they are using to make these vaccines is new. There's been a lot of stuff published about what it does/doesn't do to your body. From my understanding, a true vaccine will prevent you from getting something (polio). These are more like the flu shot. They make a guesstimate of the variant, and try to match it with a shot. You still can get it, but the symptoms "won't be as bad." Most vaccines took years of experimentation to perfect. These were done in less than a year. Depending on who's statistics you read, the numbers of infected/hospitalized/dead/dying/etc vary. Around me, they love to report on the number of new "cases." Well, if I were to go to a couple places and get tested in the same county, theoretically, each of those positive tests would count as a new case. How many are actually dying of covid versus comorbidities? Remember the reports of people being listed as a covid death even if they had a stroke or MI just because they tested positive? When the prior administration was in office, the shot was a bad thing. Now, with the new administration, the shot is becoming a mandatory thing. Vax cards were never going to be required. Masking and shut-downs were going to be a short-term thing. Here we are now, and just look. Austria and Germany have announced plans for mandatory vaccination of ALL people. Unvaccinated people will not be allowed to go anywhere outside of their homes except for work, grocery shopping, and the doctor. Police will have authority to randomly stop people and check them for their vaccination status. Australia was even worse, preventing people from leaving their houses, and crossing counties. (Unless you were a soccer team.) The people started rioting. Politics has become so intertwined with all of this that I cannot even go there without using lots of swearing. Fauci, the Wuhan lab, natural immunity , one mask/two masks, 6-foot distancing, Ivermectin, vitamin D, etc., etc., etc. I'm just so sick and tired of it all. It seems like stuff that was tin-foil hat theories six months ago is coming true now. What the hell is going on? I have natural immunity for now, but apparently, that doesn't matter. I'm a bad person because I don't want to get this new, still experimental shot injected into my body yet. I'm a paria and an outcast. Big pharma seems to be the only ones getting rich off of all of this. I want to wait for a while longer before I get jabbed. I want more evidence of how effective and what the side effects of these shots are. Then I will decide on what to put into my body. After all, wasn't that a big thing in the 60's and 70's? "My body. My choice." ?? Sorry. Rant off.
  19. Damn shame about Mobey. I guess that we're all getting up there. Glad to hear that you're healing, Ruff. What happened to the patient that assaulted you? Any charges pending? Years ago, I had a fancy Lincoln up on the sidewalk against a telephone pole. Guy in a suit behind the wheel looked like a hypoglycemic pt. Crouched down next to the door, and asked how he was doing. Next thing I know, I'm on my ass and my jaw hurts. Dude has the car started, motor revved up, and is trying to shift into reverse, but his foot is still on the brake pedal. My partner is walking behind the car, so I reached in trying to shift it to park, or turn the keys off. Guy grabs my arm, and just chomped down on it like an ear of corn. My partner hears me yelling, sees me get loose, and the guy proceed to start laying into me. He comes over and literally falls on the guy shoving him into the seat (He was about 350 lbs back then.) We finally get him out of the car onto the ground as the cavalry arrives to back us up after our distress call went out. Turns out that the guy had been high on coke and crack. He had been driving from one side of town to the other before he passed out and glided onto the sidewalk into the pole. He developed Rhabdo and was in the ICU for a while after our adventure. I filed a report with PD. He was charged, and I went after him in a civil suit. His attorney was real smarmy about the whole thing right up until they said that I had no permanent damage from the incident, and I showed them the scar on my arm. They agreed to damages real quick after that. Not every pt is innocent.
  20. I used to be really active here back when there was the flashchat. It's been a LONG time. So, I am in school and I am just looking for some feedback on a medical scenario for an assignment. I have my own ideas, but I just want to ensure that I am on the right track. Prompt: Consider the following scenario: Ms. Craft, age 59, was brought by ambulance to the emergency room because she thought she was dying. She had difficulty breathing, was dizzy if she attempted to sit up, and felt a sense of impending doom. Ms. Craft assumed that she was having a heart attack, and so did the admitting emergency room personnel. But the case was more complicated. Physical examination showed Ms. Craft to have weakness, malaise, warm skin, and hypotension. Ms. Craft said she felt nauseous. A blood glucose value was really high. Cardiac markers did not show that she was having a heart attack, nor did an EKG. When her history was taken, Ms. Craft said she had not seen a doctor in several years and was unaware that she had diabetes. Her respirations were deep and rapid—Kussmaul respirations. In this case, the ER physician diagnosed decompensated diabetes mellitus with metabolic acidosis. These were the medications prescribed: • Oxygen by mask • Hypertonic IV fluids • Insulin orally • Hydrochloric acid solution via IV In a short paper, the following critical elements must be addressed: • Identify the incorrect medication/drug classification/treatment and explain why it is incorrect. • What drug classification would you use instead? Why? • Provide an example of a generic medication from each drug classification. How would each of the medications/treatments in the scenario act on the patient's body?
  21. OKAY, yes, I know these are definitely older and no longer top of the line. That said and acknowledged, we are a rural fire district that has never done vary many transports, leaving that to private ambulance companies. These days that is having to change due to a combination of COVID, economy, scarcity of EMTs, and VERY LONG turn around times at ER. So, we are now transporting about an hour each way over rural (bumpy) roads. Many of our patients are elderly. We have resolved to add automatic or semi-automatic vital sign monitoring to supplement our all-manual current practice. Because of price, availability, and reputation and a generous in-kind donation of several of them, we have decided to go with the Welch Allyn ProPaq Encore line. We have mostly 202EL and 206 EL units, with Option Numbers of mostly 223 and 225. These units, therefore, use Nellcor SpO2 sensors but from there I am confused. Some say MP-203 sensor and some say MP-507 sensors. I have also been told that Nellcor DS-100A sensors are what we need and I can find off-brand replacements for those. I particularly want to maintain the motion tolerance that made these model popular "back in the day." Can anyone help me with which goes with what for the SpO2 sensors? Also, a smaller matter is that I cannot find even a part number for the DC (12 volt) three-pin power cables. Thanks so much for any info, wisdom, suggestions or hand-holding anyone can provide. Take care everyone!
  22. I had to look back, so no idea why it's under Funny Stuff. While the question of 3 Strike Rules might be hypothetical, I feel that, hypothetically, the aforementioned Malpractice by failure to act could be applied, at someone, or an agency's expense, in the millions of $$$.
  23. 1) Why is this posted in "Funny Stuff"? 2) Who made any of us judge, jury, and executioner? When someone calls in emergent medical distress, my job is to answer that call not engage in social judgement as to why that person ended up in a particular situation. 3) Previous forms of "3 strike rules" have been complete, epic, failures. Why should this particular line of thinking be allowed to prevail?
  24. Sorry to hear. Rest and healing to his family and loved ones as they work through this.
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