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  2. Kmedic82

    PALS

    My PALS study app went live today for Android. If you are getting ready to take PALS, check it out. https://play.google.com/store/apps/details?id=com.wPALSQuiz2019_9326200 PALS Study Quiz 2019 I am new to developing and plan on making more. I would like some constructive criticism!
  3. My PALS study app just went live for android. If you are preparing to take PALS, please check it out!

    PALS Quiz 2019

  4. Kmedic82

    PALS Study App

    My new PALS study app just went live today! If you are an android and getting ready to take PALS, check it out! https://play.google.com/store/apps/details?id=com.wPALSQuiz2019_9326200 View the full article
  5. Hey Defiant1 - if you are willing to move - our service is hiring EMT's, probably pays more than what you are making now. If you get in medic school you could easily pull in around 65000 a year and that's a conservative estimate after you get out of medic school. We are in a rural area of missouri - 55 miles south of Kansas city - running about 2000 calls a year. If you can get your missouri license and willing to move we can always use a good EMT who has aspirations to go to medic school. Hey Defiant1 - if you are willing to move - our service is hiring EMT's, probably pays more than what you are making now. If you get in medic school you could easily pull in around 65000 a year and that's a conservative estimate after you get out of medic school. We are in a rural area of missouri - 55 miles south of Kansas city - running about 2000 calls a year. If you can get your missouri license and willing to move we can always use a good EMT who has aspirations to go to medic school.
  6. Problem is, we've been told over and over that we are not doctors and the only way to determine if someone is truly having a medical emergency is to transport them to the ER for evaluation. Every medic I know is not willing to risk their licensure in order to buck the system and tell a patient that they don't qualify for a ambulance and they need to find another way to the hospital. They not in a million years want to be the test case for a patient who truly didn't need an ambulance yet that patient felt they needed one for that stubbed toe or small laceration or what not and the patient sue that ambulance service and the medic with the Case resting on "what training did that medic have to rule out that I wasn't truly having a medical emergency that didn't require an ambulance transport???" Because we all know that many ambulance services will drop that medic and not support him/her for turfing that patient off to a UBER or a taxi cab even if there was a policy or guideline or protocol that in all actuality supported the medic refusing transport but the ambulance service see's a loss of the legal case in both the court of law and the court of public appeal. The medic is the one who is going to lose out in the end. I'm not willing to risk my license just to turf a patient just to save my company a dollar or two policy/guideline/protocol or no and I don't think many of my colleagues will be willing to either.
  7. In reference to feeling ready to quit? For a year or two at least with my letter written and ready to hand in. My average so far over the past 3 years has been around 57 hours a week (thats not including my shifts left for this week). I've done 80-hour weeks where I'm essentially living at the station. Granted, 500 calls a year is probably a month for her, but its still "I can probably move into the station and be slightly ahead" I totally understand the outrage of pay, I think being paid double what the general EMT's are paid due to being an officer (minimum wage for basic, $7.5/ hr for AEMT), but the village workers entry-level is higher than mine. If not for state retirement and health insurance, I'd have probably left long ago. Honestly I'd love to be making her 17/hr though when I'm down around 13.
  8. She said she is leaving the job due to a "toxic and dangerous environment" and wrote a letter to the city explaining why. How many of you out there are close to experiencing this? Here is the full article: https://fox8.com/2019/08/13/i-team-paramedic-writes-explosive-letter-to-city-leaders/?fbclid=IwAR2MPc9D5iZ2qHHdXcIfJ9LQ-GcpuZvK6BLjOUV0nbRGqOR8DHPeM0HOlkQ
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  10. There doesn't have to be a statute. The fact is that any ambulance service, private or not, that refuses transportation in an emergency is almost guaranteed to be hit with civil litigation from the patient or their family, with the additional possibility of criminal charges from negligence if the person dies from the direct result of a denied emergency transport. Any competent ambulance service understands this well.
  11. So, here's a thought, one that you might want to think about. I have a Misdemeanor conviction from 1986. I plead guilty, paid fine, went on my merry way. Was told that it didn't show up anymore after 15 or more years. So color me surprised when.... about 4 years ago, had a job that I really wanted, they did a background check, and guess what showed up. Yeppers, that conviction. Thank goodness I put down the info about the conviction otherwise I would have lost out on the job. Just be careful about not telling an employer about convictions that you don't think will show up sometimes will and if you lied about them on your application and they find out you lied - your job is history. Word to the wise.
  12. I recently had a care accident and my car was total. I have fracture ribs and currently going under Physical Therapy... A month 1/2, after the Therapy started I went to floss my teeth and a flood of blood occurred. My husband ran and got lots of gauges to try to stop the bleeding...which took more than 15 minutes. I went back to Physical Therapy the next day and mentioned what happen....They were reluctant to acknowledged that the cause of this event was the car accident...I plan to go to a Neurologist as I need to make sure that this event was not caused by the car accident. What do you think?
  13. Hi, Can you clarify what a NEMT company is? I have not heard of it.
  14. Hi my name is Anna, I have a NEMT company for few years now and I am interested and looking forward to start with EMT as well, Any suggestions? Can anyone tell me what the steps are and what I am exactly supposed to do in order to start the process? what the requirements are and so forth?
  15. No problem! Good luck with your career pursuit. Come back sometime and tell us how your course went.
  16. Thanks, called my local DMV and they said it didn't show anymore. Thanks for replying!
  17. @emtwannbe3, Your post indicates to me more of a desire to enhance the current education that first respondents currently possess about behavior emergencies rather than going into EMS. Given your academic history, you seem to be in a great position to format your ideas into a program that would help everyone involved with patients experiencing an issue. I would recommend seeking some ride-along time to understand the challenges of the first respondents to gain insight on the real views first respondents have about patients that suffer from psychiatric or behavioral emergencies.
  18. My service uses Panasonic Toughbooks, all of which are getting older. We intend to replace them in the next budget year. I'm looking for input, pros/cons of staying with the Toughbook or going to another device.
  19. Almost every controlled drug in my daily carry has significant abuse potential in the wrong hands. Why should best practice patient care be compromised because someone might abuse it? What opiate would you suggest a service carry instead when all opiates, benzo's etc. have abuse potential?
  20. Before you ask- Yes, I take the medication that's prescribed to me. Yes, I attend regular appointments with a psychotherapist and psychiatric physician. No, I don't use drugs or alcohol. No, I've never been convicted of a criminal offense. Yes, I'm employed, and have been employed continuously for several years. No, I don't have any history of violent behavior. No, I don't own any guns, and no, I'm not interested in guns. Probably about the most violent thing I've ever done in my entire life is go fishing. Yes, I graduated from a 4-year college (Occidental College, where Barack Obama went, with a 3.7 GPA including math, biology, and hard science classes [i.e. I am NOT mentally retarded]), and yes, I've been able to complete a one-year diploma (accounting/bookkeeping) since then. Yes, I'm aware that being an EMT isn't like how it is on TV, and the reality of it is that it's a stressful and emotionally draining line of work. So is working in restaurant kitchens, which I've been doing for the past three years (I previously worked in bookkeeping, I didn't like it, it's too solitary and boring, I don't like being overhead, and I like working with my hands). I was a pre-med student in college, but, obviously, that didn't work out for me. I've done extensive volunteer work in the past with a hospital, an animal shelter, a buddhist temple, and a food bank, if that makes any difference to you. Please forgive my defensiveness, but people can be rather judgmental toward 'the mentally ill' these days. That's understandable, but remember that almost 20% of Americans are 'on meds' by this point. Some people do eventually "get better" from that, but it takes a lot of work. I'm interested in becoming an EMT. I see all this stuff going on in the news, I get the impression most first responders have basically no clue how to deal with a 'mental patient,' other than kill them, or beat them up and tranquilize them, and I want to do something about it. However, I don't know how extensive of pre-employment background checks EMTs are subject to, and whether or not an involuntary psychiatric hospitalization from 10+ years ago would show up on one (let me repeat that I am NOT a criminal, I have no history of "violent behavior," and I have never been convicted of a crime other than minor traffic violations). Are there lines of work in EMS that require more or less extensive background checks than others? Please forgive me if this question has been asked and answered elsewhere on the forums, but I was hoping someone with experience in the field might be able to answer it before I start investing time and money in the training. Thank you for taking the time to read my post, and I appreciate any response you might have to offer!
  21. Kmedic82

    ElPaso Shooting

    apple.news/APWZMplLkQp28qw0aiF26Vw I couldn’t imagine being first on scene… prays for EVERYONE involved. View the full article
  22. @EMTconcerned, what was the outcome of the situation? Praying that the medic received help. If you'd like, please share my own situation. After an abusive/emotionally childhood, a wrecking ball twenties, a shit load of PTSD from the field, my drinking became a HUGE problem to my family and marriage. Not to mention, the cloud of anger I sat in at work. Long story short, I quit drinking and began therapy. Therapy was amazing but uncovered that there were some terrifying skeletons in my closet. I went into a manic episode and was almost successful at killing myself, twice. Once at home after trashing my house and then a second time after escaping the hospital. Needless to say, I was locked away for almost two month. My employer was amazing. Helped with FMLA paper work. Gifted my family with grocery gift certificates. Etc. They are even wanting me to start a first responder mental health class for our academy. But, if I worked at any other service, I know I would have lost my job and potentially ended my career. Coming form the patient stand point, your medic needs to address what the real problem is. It's hard. It hurts. It's painful as hell. There is a light at the end of the tunnel. These psych issues are something she will have to manage her entire life. It becomes a life style and your loved one need to educate to help your life style and call you out with you begin "spinning." Spinning is my wife's code word for "check yo self." Praying she received help and fought those demons. She was hitting a scary rock bottom. *******IF ANYONE READING THIS NEEDS TO PRIVATELY TALK TO SOME ONE ABOUT THEIR OWN ISSUES, PLEASE EMAIL ME!!! I AM HERE TO HELP FROM THE PATIENT AND PROVIDER STAND POINT. YOU DESERVE HAPPINESS LIKE EVERYONE ELSE.***********
  23. Recently, at my former employer (private EMS), we had an EMT who had some sort of mental episode. We came back from a trip and there were 3 officers in the management office and eventually PD took him to the hospital for a psych eval, and he was discharged the same day. The company owner even stoodby with him at the hospital and brought him back to station so he can clock out and go home, acting like she was concerned. A few days later, he was terminated. Management was quick to say it was not because of a mental health issue. So, they found some trivial issue to terminate him so they wouldnt have to deal with him it sounded like. Like it was said above, private EMS doesnt care. Last I checked he was alright. Maybe you can get this coworkers confidence and try to figure out whats wrong?
  24. Around here, the 9-1-1 services do not have pillows on-board. The hospitals all seem to be in short supply. We ask the patient at their house or facility if they would like to grab on of their pillows for comfort. Otherwise, its a short trip to the hospital. The private services seem to have them that they grab from the nursing homes usually.
  25. Dont beat me up too bad here but I feel I am having a conflict of conscious. I have been in EMS (both fire and private) for nearly 3 years now. Time and time again, I see, on the private side, patients who are getting an ambulance ride when they really do not qualify. Attached are the forms in use in Ohio. One is for wheelchair/ambulette's, the other for ambulance/stretcher transport. At the bottom, it clearly says, "False certification constitutes Medicaid fraud." The social workers at the hospital like to use "qualifiers" to make it acceptable. With as busy as we are, I feel we shouldnt take patients who do not qualify for our service because, its fraudulent and I fear of somehow getting implicated or in trouble. My former private employer would decline these trips if we questioned them (patient was walking around, had family that could transport, etc). My current employer essentially says we are there to transport and to conduct the trip, document it and let billing sort it out. I feel the current employers feelings on it set some unsuspecting patient up to get a bill they may have not expected. Anyone ever run in to this problem??
  26. This study will have two versions written about it. This version is my “cut the fat” version I am trying encapsulate in this blog. As well, with my venture in medical free lance writing, I will have a “medical education” category for those who want the juicy morsels of dense medical language. With out further wait… here is sepsis study on a plate. Sepsis is a hot button topic in the world of prehospital medicine. There has been alot of literature put out by hospitals that declare more than 50% of in hospital deaths are due to multiple organ death (MODs), which is the ultimate deathly out come of sepsis. The problem with sepsis and EMS is not only figuring out what we are looking for, but also to relay to the ER what we are seeing. Granted, we are not allowed to fully “diagnose” a patient, but effect EMS education teaches differential diagnosis to create a “field diagnosis.” We want to start drawing the picture of what the patient will need for continuity of care. Depending where you work, ER nurses and docs alike appreciate a field diagnosis. Again, depending where you work. In order to have that continuity of care, the EMS provider has to be ready to give the facts and findings of your field diagnosis. Center stage at hospital night at the Apollo. Your are taking your patient to bay 1. There are 20 people in lead vests and gowns and goggles. You begin to speak loudly (que Eminem walking to the mic) and clearly. Then you are interrupted by questions you don’t know. The whole set falls apart. The crowd begins to boo. The doctors glare. The nurses snicker. The a clown with a long curved cane scoops you up and drags you to the ambulance bay… But never fear! Sepsis study’s for ambulances are here! For a potential Sepsis activation, you need to first understand the steps of infection and it’s relation to the human body. I’m sure many of us have had the case of chest pain that ended up being pneumonia. Productive cough? Elevated temp? Could still be cardiac but through our deferential diagnosis we know we have a higher chance or treating pneumonia instead of angina. Breathing treatment and fluid versus aspirin/nitro. Entrance into the portal of infection evil…There are three steps in the chain of fatal sepsis. First step is Systemic Inflammatory Response. This is the time when majority of people of who feel ill take tylenol and get rest. The body is giving basic signals that it is fighting an infection. Next is Sepsis. This in an untreated infection. The infection is now spreading into the blood stream (septicemia) and fluids begin shunting to organs to protect the body from shutting down. A patient can be altered, have low BP, elevated heart rate, tachypnia and elevated temperature. The blood vessels dilate, in effort to protect the organs, and the patient starts to present with signs of shock. “The situation is usually made worse by the damaging effects of the toxins on tissues combine with the increased cell activity caused by accompanying fever.” The next phase can be the deadly end. Multiple Organ Death (MODs) is when one by one the organs begin dying off. The body begins losing the battle against the infection. EMS’s mission in this equation is early recognition. Criteria for sepsis activation in prehospital is still developing. IStats. Sports medicine lactate testers. Many tools have been dropped off in our jump bags. A study performed in Albequre, New Mexico, hospitals worked along side EMS in order to start prehospital sepsis activation. The study hypothesized that, “in patients that EMS sepsis alert criteria, there is a strong relationship between prehospital ETCO2 readings and the outcome of diagnosed infection. The secondary hypothesis was that ETCO2 also predicted hospital admission, ICU admission and death.” Yup. The same tool used to treat respiratory problems and help declare ROSC can be extremely useful in alerting the hospital if your patient is about to go into septic shock. Alburqure created a field sepsis protocol. Hospital alerts were initiated if there was a suspicion of infection and certain criteria met with; temperature reading >38.3 or <36 c, heart rate greater than age expectation, hypotension, elevated lactate readings, elevated respiratory rate, and hypocapnia. This is NOT the EMS protocol. It is a visual to help understand what creates the criteria.As with any form of shock, a body that is in a sepsis state compensates to save valuable life saving organs. As vessels begin to shunt, you have standard shock symptoms included with infection symptoms. A sample sepsis protocol for preshospital.So what was the result with the study? Out of the 351 patients that met criteria over the course of a year for Field Sepsis, all patient’s MET the criteria! It worked!! EMS was successful in diagnosing sepsis in the field. Plus, they created a form of communication and trust with their local hospital. I know many of us are cardiology gurus. We love what we can fix in the field. Truly, it is amazing what we can do to the human heart for survival. Now infection is the next focus for saving lives. Study quoted: Sepsis alerts in EMS and the results of pre-hospital ETCO2; from American Journal of Emergency Medicine, 2018 Sepsis 3.0 https://www.ems1.com/ems-products/Capnography/articles/82616048-Sepsis-3-0-Implications-for-paramedics-and-prehospital-care/ PulmCrit: The surviving sepsis campaign 1-hour bundle is… back? PulmCrit: The surviving sepsis campaign 1-hour bundle is… back? From the hospital view. https://emcrit.org/pulmcrit/ssc-1-hour/ View the full article
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