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When I became an EMT-Basic I took the state test administered here in Texas. When I became a paramedic I took the NREMT-P test. I let my NREMT-P go after the two years were up and I work for a municipal service. I saw no point in paying someone money every two years just so I could have the ability to move to another state. The NREMT-P test is not difficult, it is not tricky, it is just like every other assessment/exit/capstone type test. My instructor didn't teach NREMT-P, he kept on teaching us how to be paramedics. He told us to review our notes, to take our time, read each question, and think about what you'd do first, second, third. I get tired of people saying that the problem is only NREMT. I don't agree with NREMT, but it is better then no standardized testing at all. The only way EMS is ever going to progress is for it to become more uniform. A paramedic should be the same "type" in every state. The same for other levels. -Nate

Ahem... Canada... That is all... It still amazes me the discussions that persist on the need of EMS education in the USA. These discussions don't happen in Ontario (and I would imagine the rest of Canada). You don't hear people trying to rationalize away the need for a 2 year college diploma to be BLS in Ontario. The need for a further 1-2 years to be ALS or critical care. You don't want to do the education? You aren't in EMS, period. There is NO ONE educated in Ontario in paramedicine in the last 10 years (well, there are a very small minority with less but anyway) that DOES NOT have a 2 year college degree MINIMUM to work BLS in the province. The fact of the matter is that the vast majority of the people that post on this forum would never be able to work in Ontario, or a large portion of Canada without totally restarting the educational process. Oh, and save the "arrogant Canadian" post that I'm sure will come up.

So, according to your numbers, FD's only respond to 20% fire calls. Just because CA just stabilizes and transports does not mean the rest of the Country does EMS this way. We have tried, to obviously no avail, to explain to you that CA does EMS poorly. Do not judge my chosen profession by the way CA does it. I have never had any desire to be a fireman and still don't. I don't care if thousands of out of State applicants apply to your dept. The issue is and always will be EMS is a way for more knuckle draggers to get on to a FD. EMS should be seperate from the FD. Since you say 80% of your FD calls are EMS related, shouldn't EMS be making your 150,000 per annum and the FD considerably less? The first line in your comment would be comical if it wasn't so very disturbing at the same time. You just don't get it. It is ALL about patient care! Not just to some extent! Oh, and I fixed your quote. See if you can spot the changes.

It would be pointless to argue anything medical with you since you seem to have missed the 80% EMS calls in your own post. Since I have spent 30 years in EMS, your comments really don't scare me "out of EMS". You scare me for knowing you and others like you are allowed to do come near patients. As for the out of state applications, you are in California. We get the out of state applications also but very much like California, once an applicant realizes why our wages are higher and that their chances of raising a family complete with a house and car are slim to none, few stick around. It truly has nothing to do with your FD especially for those who are serious about being a good Paramedic. Those out of state applicants have probably blanketed the state with their applications to every FD. Seattle is more highly sort after since it is a challenge to get a job that requires dedication, ambition, intelligence as well as the physical fitness of a FF. There are also many other outstanding FDs that take EMS seriously. However, in Southern CA that in not the case and usually the studies done in your area are to show your Paramedics can not perform some of the basic skills in EMS such as intubation or 12-lead ECGs which are then used to reflect negatively on EMS. Other FDs and EMS agencies such as Seattle and Wake County have shown quite the opposite. I am sure there are a few really good Paramedics in your FD but as you said "strength in numbers". Thus, for those for good Paramedics, it would be difficult to soar like an eagle when you are working with a flock of turkeys.

Or do like we did - formed a safety committee at which one of the first items brought up was the unacceptable mode of transport of pediatric patients. Result - Pedi Mates on every rig. I'm pretty proud of that.

If someone is passing their class with flying colors, and failing NR...It's not time to look at NR, you should be looking at what the class is teaching or not teaching. NR is nationwide... people pass it all the time with no problem, so how are those people passing? They had a good school behind their education. It is the EMS education system that needs higher standards. Medic mills and poorly trained instructors are the problem not the NR test. If we want to be taken seriously by other medical professionals we need to have a national standard to practice. Someone already mentioned NCLEX for nursing, the USMLE for the docs and there are tons of other accreditation sources out there. If we as EMS don't have a national test and standards, we are regressing and not progressing in the medical field.

One of the PhD students at uni has been focusing on ventilation during cardiac arrest and the effectiveness of different sized bags. As I understand it, he is trying to get the ambulance service to ditch the adult size BVM (1600mls) and recommend the paeds BVM (1000mls)for vents during adult cardiac arrest. He's published a number of papers to that affect. Nehme Z, Boyle M. Smaller self-inflating bags produce greater guideline consistent ventilation in simulated cardiopulmonary resuscitation. BMC Emerg Med. 2009;9(4). Nehme Z, Boyle M. Accuracy of bag ventilation in simulated resuscitation. Journal of Paramedic Practice. 2009;1(4):167-72. In the interests of privacy I suppose I should not say which of the two authors is the student in question. I couldn't remove the bold format from Boyle M for some reason, its not necessarily him. The following values were considered desirable, apparently, as per ILCOR guidelines. 1. a ventilation rate between 8 and 10, inclusive; 2. a tidal volume between 480 ml and 560 ml inclusive (based on 6–7 ml/kg for the 80 kg simulated patient); and 3. a minute volume between 3840 ml and 5600 ml inclusive (based on multiple of lowest and highest acceptable ventilation rate and tidal volume). I was wondering what everyone here thought about the idea. As an aside, there was no mention of artificial airway type that I've noticed in the papers. I was wondering if this could be considered a confounding variable. I have used the lung simulator in question and its attachments are probably most similar to ETT pt. Could the airway type make a difference to the outcome?

Diazepam618 (or whatever name he happens to use on the other forums) is probably just trolling to get responses since he has had difficulty in keeping his statements consistent. I also have not seen him spouting such stuff on a FF forum. I seriously doubt if his FF buddies would be as receptive of him for presenting them as a bunch of uncaring, unprofessional EMS providers or FireFighters who care very little for the public they serve. There is also a good chance he is not with a FD or he would already know this.

I guess the real difference is that EMS doesn't need pop culture to make us feel good about ourselves. Seriously, what's wrong with the fire service when they point to movies to make them feel important? Talk about a little short man syndrome there. Oh, and awesome PR on The Academy. You know, with all of the cheating going on that apparently the instructors thinks just deserves a slap on the wrist. 'Oh... you cheated. That's no good. Here, sign this paper and you're free to go on with the academy and life.'

You have no soul and no professionalism. You don't care about medicine. Why are you here?

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.

You have changed your pay and hours worked way too many times in the various threads and forums for any of your statements to have much credibility. It is not that difficult for anyone to check your base pay on the FD's website.

I am only talking about the medical professions. However, I think you may find Accountants and quite a few other professions on the same page. Name one licensed health care profession that relies on a tech school cert. About the only one I know of is the LVN which is no longer utilized is some states. I haven't seen an LVN in the area hospital systems in over 20 years. The few that are still there are working as PCTs which are CNAs with a few more skills and a little more education. The title of LVN is no longer recognized or placed on any name badge. Upgrade piece mill? RT and RN did not put in a few extra piece mill patches between diploma and degree. They announced the degree would be the minimum and gave about a 5 year notice. LVN and CRTTs were put on notice that they get their advanced credentials or they would no longer find themselves working in their same job areas. A few RTs were grand fathered but the hospitals embraced the educational requirements but then, the hospitals actually started rerquiring a degree for employment long before it became official. Thus, there were not many nondegreed RTs still hanging around when the change occured. If you do a little researching you will find this is true for the other allied health professions and the coming NP education requirements. Why is it that every other health care profession has a degree? Many go into it for a career. If another professional wants to change careers they probably already expect some work to do so. An Accountant or Engineer would understand the importance of education. Have you ever heard of a 6 month bookkeeper tell a Graduate school Accountant that their college education is useless? Would I want a 6 month tech school bookkeeper representing me with the IRS? Should this be good enough for patients? Is patient care all about your leisure? Why waste time at an expensive tech school earning credits that transfer nowhere? Why would anyone then start over if when the college tells them they are not giving credits for half-arses A&P classes? You say you are not anti education but then are you anti Paramedic? Do you believe the Paramedic should not join the ranks of the other medical professionals for legislative recognition? Do you believe the Paramedic is nothing more than a first aider with a feel extra advanced skills and thus a tech school training will suffice? I know you have read my posts about how and why other professions have advanced their education and I am really puzzled that you claim to be pro EMS as a FF but can not seem to see them as medical professionals. If you do not want to advance with EMS then you really should consider if you only got the Paramedic patch for a few extra dollars from the FD for your pension and not for the patient care aspect of the job. Your posts lately have only been about what the job can do for your bank account and not what you can do for the patient. Even when you were talking about getting a degree as an RN or RRT in other threads, you mentioned very little about the job or the patient care aspect. Neither you or Diazepam618 are a credit to Fire Based EMS when you fail to realize there is a patient involved.

Was just curious to know if anyone can send me a link of info for the correct placement of a rear facing car seat on a gurney with or with out the base.

I work an average of 56 hours/wk. If you discount a hour or two of PT a day plus sleeping and studying for college courses on duty, it's more like 40 hours or less XD. Plus, it's not really like work anyway. People volunteer to do this, it's so enjoyable. I make around 69k as a base, with a lower cost of living and around half the cost for housing that I had in NYC, where I was making only 60k/yr before leaving. Diazepam's cost of living may be high, but his pension will be just as high. He can leave for an area with a lower cost of living post retirement and live like a king. That's what I'm going to do. I plan to keep equity out of my house, invest it, sell my primary residence at retirement, buy another in a lower cost of living area, mortgage 80%, add the rest to my previous investments, and let the interest pay my mortgage in full, or close to it. Financially free baby! I found the NREMT about as challenging as the NYS exam. NY dosn't use it, or allow reciprocity in with the NREMT-P. IMO, it's only a necessary evil for those who want to work in another state without doing a challenge refresher.

I'm done with Para Prep and now taking some ALS stuff before Paramedic School but I'm squeezing in some time to work on "Nina" the motorcycle I've been building for a year or so, and now that Trauma's been canceled I can concentrate a bit more . . . I needed to change out the tranny belt pulley that came with the transmission I bought as rear drive belts are for fags but getting the main nut off requires a special tool. (And why does this all sound so sexual?) Julia's been back home in PA for two weeks as her Mom is ill, so that must be it . . . So I looked online and found a Sears that had a 1 and 7/8s socket in stock. It was in Glendale so I fired up the GPS and drove down there. Man, it's getting late early now, it's only 5:15 but pitch dark. This is one of those older stand alone Sears stores so I find a place to park on a side street and walk around the corner. And right into a pretty good looking hooker. "Looking for a woman?" she asked sweetly. "No, I'm looking for a socket, but thanks anyway." "That's cool, but my name's Missy, and I'm always around." The damn socket thing cost me 26 dollars, and while offering up my credit card I couldn't help thinking Missy would have been cheaper and a lot more fun. Back home I cut the socket in half with my chop saw because the transmission shaft it too long for it to fit any conventional tool. Then I added a piece of steel pipe and welded it all back together. And that went alright. The main tranny nut is a left hand thread so it's backwards and comes off clockwise, but no matter how hard I tried I couldn't budge it. I made a block so the pulley wouldn't move when I was pounding on it. And I've got a good impact wrench but a wimpy air compressor so that didn't work. I then tried beating it off with a hammer and a hand impact but that didn't work either. I then cut up a piece of steel pipe for a long breaker bar but still that didn't work. So I gave up for tonight and instead had a few beers. And just so the night isn't a total loss I'm gonna head back down to Glendale and see if I can find Missy . . .

I don't think a true and thorough discussion of the causes of World War 1 or 2 or the entry of the United States into either is possible or likely on these pages and I won't try. I would like to, however, spend a moment on the HMS Hood. HMS Hood's destruction (if I recall correctly) was a product of a chain reaction caused by the lack of flash proof shutters separating the various compartments of the turret, gun lobby, handling room and magazine from each other thus controlling chain reactions. Bismark did not have this problem due to a peacetime training incident that resulted in a similar catastrophic destruction of a German vessel and allowed them to retrofit their designs early. To the best of my recollection, the explosion of HMS Hood was what lead to the wide spread adoption of these flash shutters in other allied naval designs. Either way I'd hardly call a previously unknown design flaw a mistake. Certainly not in the same calibre as the other, much larger missteps made by both sides during the course of the War. Honestly if we leave aside the excesses of the Nazi party and the Holocaust, both of which were largely unknown publicly, and neither of which was a motivating factor for the leaders of the allies before or during the war, we have little choice but to accept that propaganda value aside, WWII had little to do with defeating evil or defending freedom and is instead a continuation of the poorly settled political issues of the first world war. And of course the First World War had more to do with arms races and old school imperialism than it did Arch Duke Ferdinand. This isn't meant to diminish the extreme evil of the Holocaust, the mistreatment of prisoners, or the other evil deeds of the Nazis under Hitler, but instead to remind us that hindsight is 20-20 and how we view the war now does not necessarily represent the motivations of the various world leaders at that time. This is also more productive then actually engaging with sansbacon. Now who want's to watch "Band of Brothers" or "The Devil's Brigade?"

46Young you are making a LOT of assumptions, most of them questionable. 1. The assumptions of poor spending habits by the college grad but good investing discipline by the non-college person. 2. Assuming that the college student does not work and earn money while in college. 3. Assumption that the non-college student has the ability to pay that extra 10K up front for the tech course. 4. Assumption that the student has ability to invest this mythical $10K in order to make the earnings difference (or that they can get that fantabulous 10% rate). 5. You are ignoring the chance college students have to get a student loan or grant which will let the acquire education without delay. Tech students do not have this opportunity. Therefor, you fail to account for missed earnings for the non-college person who is forced to spend time in a lesser paying job saving money to be spent on tech school. 6. You are also mischaracterizing the length of an AAS Paramedicine versus a tech school options. Tech school is generally going to be 6-12 months (we aren't counting medic mills). You are cheating yourself if you don't do college level A&P and many tech schools require it anyways. AAS Paramedic Programs are generally the same length as the trade school for the paramedic portion. One will find that there is really only about 1 extra semester of courses required to earn an AAS in paramedicine, and those courses could actually be done by the student when they are doing A&P. 7. You are also making a fatal assumption: that the education requirements for paramedicine will remain static. AAS will hopefully become the minimum. CONCLUSION: Really, you are making a lot of weak arguments and strawman arguments for tech school being more lucrative. Your argument only works for a small subset of people with very limited aspirations under certain conditional futures. It's a bad bet for the individual and it's a bad bet for EMS. Why push that agenda at all? Your troglodyte attitude is irritating. Don't be an RN for the money. You'd better be smart enough and want to do the job. BTW, it's REALLY hard to find a job as a new graduate these days in many areas (having a BSN helps and may eventually become the minimum). There just aren't new grad positions available due the bad economy + schools being flooded by people who think that RN=easy$. Your "be a hero, be a medic ASAP" comment reeks of a lack of professionalism. You honestly seem much more interested in fire than medicine. So why are you on this forum anyways?

But, when it comes to being a medical professional, one should not just settle for the bare minimum especially when that minimum is measured in "hours of training". You are providing care to patients and not putting seats in cars. Patients deserve a health care provider who is there for them even though a good retirement plan is nice. There is not another health care professional that can now say a degree is not necessary. Many employers are now requiring at least one degree higher than the minimum. For RN, many positions are wanting a BSN as the 2 year degree is just not enough any longer for the fast pace of medicine in many places. The same for RRT. The RN and the RRT are also now way behind what the other allied health professions require. If one just wants to be a FF like Diazepam618 who has no interest in anything medical, then so be it. A few weeks at a Fire Academy should be enough and I do not agree that those like Diazepam618 should be made to take a Paramedic course. It just shows how ridiculously dumbed down the Paramedic patch has become in some areas and drags down the profession. Why should the degree only be for those who want to move on to RN or some other profession? Why is education not necessary for the "field" Paramedic? I find this rather insulting especially for those who have gotten a degree as a Paramedic to provide care at a more educated level rather than just from what is learned in a 10th grade text book. Again, this tech mentality has to go away for this profession to gain respect and take its place amongst the other professionals to gain any type of recognition from those that make the legislation for reimbursement. A mere 2 year degree is not much considering what other professions, medical and non-medial, require. You are truly a minimalist. The RN is but a 2 year degree. Right now the Paramedic cert in CA and most other states is only about "1000 hours of training". Do you really consider that too much or a whole lifetime of education and totally unobtainable? You have really been hanging out with some very unmotivated FFs way too long.

I have a Bachelors of Business Administration with a double minor in strategic planning and finance. The trend for most management positions is moving towards degreed individuals. I don't think that a typical bachelors degree in science (even specialized in EMS) is going to give you enough training to be an effective manager. I honestly feel that A&P, Chemistry, Biology, Organic Biology, Cell Biology, and Genetics are all classes that should be incorporated into any paramedic program featuring a four year science degree. The best way to look at it is the BSN (Bachelors of Science Nursing). I guess you could say it'd be a BSP. Education is always for the best, however most degrees only show that you can learn. Specialized degrees like science and business degrees give you the toolset and knowledge needed to understand complex situations and take them apart bit by bit. -Nate

Just whatever you do, please do not let the mother or father hold the child while strapped onto the cot like I see done so often around Houston. That is just flat out irresponsible and very dangerous. -Nate

If you want to make some $$$$, get your RN, if you want to be a hero get into medic school as fast as you can so the FD can pick you, but if you want to make peanuts be a private medic.

Heyyyyy...those are nice. I was aware of thepedi-pac, but not of the pedi-mate. Nice job Kaisu...it's just been placed at the top of my shopping list. Thanks!!

Fortunately all Paramedic programs in California must be accedited by CoAEMSP. However, not all are created equal. If one reads the posts by Diazepam618, you may get an idea of the type of Paramedic Daniel Freeman might graduate. Interest in patient care is not a requirement. Disadvantages to a tech school is the lack of transferable credits. If you are accepted into a community college to do real college level A&P and Pharmacology, it isn't that much of a stretch to stay with a reputable school. You may want to advance your career by going into education or even get a promotion at the FD where a degree will be a head start. You also can get a certificate as a Paramedic at a local college without doing the whole 2 year degree. Someday EMS may even promote the 2 year degree as Oregon (and one other midwest state I can never remember) has already established and those college credits will have given you a good head start. Don't depend on any tech school credits to transfer and even if a few hours are given for the patch, they will fall very short. Also never look at a college education as wasting or locking up your life as some shortcuts may come back to haunt you severely later if you have any ambition for future endeavors. The price per credit hour at a California Community College is almost obscenely cheap at around $25/credit hour. Get your education while these prices last. Paying less then $3000 for a whole 2 year college degree beats a $12,000 medic mill cert. For that price you can have something more challenging at Loma Linda Medical University. Work experience is good but this "street smarts" attitude has also kept EMS providers as "trade" school techs and identified by a few technical skills rather than being recognized as EDUCATED MEDICAL professionals. This has held EMS back in legislative issues for reimbursement at state and Federal levels. One can get an education and then have the "street smarts" stuff make sense with a medical explanation rather than "this is the way we've always done it" or "just follow the recipe". Now if you just want to be a FF, ignor all advice here and follow the lead of the Diazepam618s who brag about making $100K while working well over 3000 hours/year with the FD and patient care is the furtherest thing from their minds. However, you can still be a FF/Paramedic but if you want to be a good Paramedic and not do a disservice to the patients and taxpayors, get a proper education.

NR test is easy. It is not a scam. It is not set up to make you fail the first time. I passed the first time. If someone has to take such an easy test 4-5 times just to get an 70%, maybe EMS isn't for them. Further, you don't seem to be a big fan of standards and verification. Without NR, you cannot think of moving between states. You'd have to take paramedic or emt school all over again. Other medical professions have national standards. A NCLEX licensed nurse with a degree from a properly accredited institution can move from state to state without having to take nursing school over again. Lacking national standards makes us look like even more of a joke to insurance which keeps reimbursement low and our pay low. The NR isn't perfect. It's standards should be increased. Moving the opposite direction and eliminating it will just be another step in relegating EMS to the backwaters. If you want an example of how NREMT fails us, IAFF likes NREMT because it let's them send their FF's to medic mills in other states. Of course, if NR was gone, there'd just be more medic mills locally. In my state, you can recert as an EMT with only 36 CE hours and Paramedic with only 50. NR requires 72 out of everyone. Further, the standard for classes to meet national (and thus NREMT) standards are different than the states. In my state, you could teach a state EMT class with less than 100 contact hours. Nationally, the new standard will be nearly 200 hours with more subject matter required to be covered. There are standards, albeit low. The national standards are almost universally higher than state standards.

At my station we drill, drill and drill, and run calls in between drills.

I must admit, I'm disappointed. I was accepted as a medical volunteer at the 2010 Olympics. My post is located at the Whistler Sliding Centre. I was quite excited to be a part of the Olympic experience because I will likely never have the opportunity to take part in it again. At the moment, I am drafting my letter to VANOC to withdraw my status as an Olympic volunteer. I doubt that one volunteer from one venue will be all that significant, but I will pass my resignation on to my counterparts and perhaps something will get started.

ohhhhhhhhhhhhhhhhhh now I understand his statement

How is the "new" Paramedic an I-99???????????????????? Also, states can ignore the NREMT and do what they want at the state level.

Oh, and another thing... Kevinbutnotbacon accuses me, after being notified of the assignment, delayed responding to set up taping a TV show, which he berates me for doing? I just found a posting on another string where he states that EMS in the UK ENCOURAGES the use of drugs by on duty personnel! At least we now know he is a complete fool, on both sides of the Atlantic ocean, as he now attacks his UK brethren, making them out to be "druggies". As he has, as of this posting, only 12 posts, perhaps they (UK members of EMT City) already gave him the beating he has been asking for, and gave it to him in extremis! (We can only hope). That, or his own drug habit(s) is causing his delusions of EMS superiority? Hopefully, at this time, we can resume the discussion this string was originally about, with my apologies to the OP for hijacking it, as it has been?

Many places you sit in your ambulance and wait. Slower places you do chores, CEU's, sleep so when night comes around and it gets busy you are ready. Often you go w/o sleep or meals.

You can only hope that they discontinue the NR. it's just a big scam anyways everyone i know doesn't even keep the NR once they get fire gigs.

Its the biggest scam I ever saw. Its setup to make you fail it the first time so you can go take it again. I know people have tooken it 4-5 times. I will be damn If I pay $70 6 times to pass a test that to say you can keep a patient breathing while on the way to the ER. That is what a class for. 70 dollars a pop *EMT-B TEST* is a joke. What ever happend to taking a state class then a test? Oh btw paying to get your CPR card and such. SCAM another money trick. It would be the best go get rid of the NR. Every state has different type of "standards" then others. So Please, quit sucking. BTW this will be my 2nd time taking the NR. If I don't pass it this time. i am getting a new job. I am nothing to have sucker and keep paying. I just take what I learned in class and go with it.

LOL, my bad butter fingers I say, but what kind of standard is there, I mean some places you get a two year degree in ems, and others you take an eight month to a year long votech class, some places require the NR and others don't. For most fire gigs where I work all you need is the state level license to be considered for a postion, So what is the standard? if you apply for a RN gig the min standard is a two year degree, we in ems have no standard not even a min with the NR. Frankly I think the NR is a joke and a scam, if it wern't so why wouldn't all states require it and all employer require that you have to maintain it?

"They are the envy of the uncivilised world," he says. American versus UK English spelling notwithstanding, he betrays the UK with HIS uncivilized attacks on a 36 year experience EMT (NOT a Paramedic). He keeps implying I didn't respond in a timely fashion to a call, when, in fact, I did. I repeat my question of how many years has he been working on an ambulance? Then, there is the question of the United States' late entry into the world wars. In the case of the First World War, it was because of the German torpedoing of the Lusitania (spelling?), a UK flagged ocean liner. Even though the German Embassy had posted advertisements in local New York papers that anyone in transit on UK flagged shipping was endangered of being torpedoes, the fact that so many Americans were killed on that ship, we decided to avenge them, and in addition to material support, we sent troops and ships. (I will bow to the conspiracy mongers, who say the Royal Mail Ship Lusitania was carrying ammunition for England, which was triggered into a secondary explosion by the torpedo from the German U-Boat: Divers exploring the wreck have seen damage supporting this theory) For the Second World War, yes, Germany and the UK had been slugging it out from 1938 (I think). We entered the war, due to the sneak attack by Japan at the American bases at Pearl Harbor, "Battleship Row", Hickham Field Air Base, and the surrounding areas of the Hawiian Islands. Japan and Germany had agreements to support each other, so we ended up in a two ocean war. And a point of order, here: Britain has also made mistakes in war. They sent an old, proud warship that was not properly equipped with armorplating against the most superior battleship of the day. The HMS Hood never got a shot off, when the first volley from Bismark hit her, and caused her to sink in less than 10 minutes, with great loss of life of HMS Hood's crew.

Saw a few episodes and was rather impressed.

History has shown that the vast majority of individuals have a poor financial eduaction, as evidenced by overextended credit, real estate speculation, underfunding 401k's etc. etc. Our example shows how one of a lesser salary can come out ahead of one that is more gainfully employed. Most college students don't work FT. I have never met any that contribute to an IRA while completing a degree. In this hypothetical situation, the candidate needs to decide whether or not to go the degree route, for financial reasons. In NY, they're only 7k or less. You make that back in the first year, plus more available OT and per diem work. My retirement portfolio is divided up int 75% equities, 15% bonds, and small hedge positions in gold, REIT's, and cash. We further divide up these asset classes into large/medium/small cap growth/value, and mainly intermediate term bonds, gov't and investment grade, with small allocations for short and long term. We use percentage based portfolio rebalancing to ensure that we're always selling low and buying high. This reduces volatility, but dosen't hamper growth. As you know, it mathematically twice as difficult for equities to rise than it is to fall. We use primarily ETF's, as retail funds are subject to bracket creep, high turnover, and style drift. Not mythical at all. It isn't that difficult. Consult with a good financial advisor in regards. A tech school may feature a watered down version of A&P and pharm. It isn't optimal, but you'll still get hired, and you can complete these requirements after graduation, at your leisure if you desire. As for me having a "fatal assumption" I feel that's a bit dramatic. If, and that's a BIG if we are required to become degreed medics, we'll have a period of time in which we can upgrade piecemeal, like other healthcare professions before us. It's FT professionals in other fields that want to become medics that would be at a disadvantage at thet point. I'm not anti - education per se, but I'm showing that there are other ways to go about things, other routes to prosperity. Tell me why it's lucrative to carry a big, long mortgage. Form one, tell me why it's lucrative to pull money out of your house. Tell me why prepaying your mortgage is foolish. I'll run financial rings around most (maybe not MBA's and the like) with four year degrees with my career choice, future degree aspirations, and financial strategies. I'm a tech school graduate and an accounting dropout currently.

I love it! Good PR for the fire service, along with the OCFA academy. I find it amusing that EMS needs dramas, with sometimes gross embellishments to pique viewer interest. With fire and police (more so fire), just let the cameras roll, and you'll have all the interesting REAL footage that you'll need. How many cop movies are there, how many fire movies are there, and how many EMS movies are there? I loved Bringing Out The Dead, BTW.

I don't know about training, but around here, as soon as a woman finds out she's pregnant, she's off work, even though most OB's say that they have no problem with a woman working into her 1st or 2nd trimester. The biggest issue I have been told is balance ans safety issues associated with that, when the woman starts getting big. I do see potential issues with training if the woman is large and needs to work on lifting techniques. It may be a liability issue for the school

Allow me the privillage to reply to your wildly absurd rant. 1) Firstly the matter of independence, you didnt beat us. History shows that we graciously allowed you your freedom on account of your questionable loyalty and fighting ability against the French, and for your skill and panache for killing native Americans. 2) The war of 1812 is a minor triffling affair and is not even recorded as a proper war such as was fought against real opponants such as the noble brave Frenchies or Spanish. Twas little more than a piffling border dispute with a minor nation. 3) Some people crueler than I may question the USA very late entry into both world wars. I however do not wish to dwell on accusations of cowardice. Suffice to say, thanks very much for the money. You saved us all from starving and freezing to death. Good on you ! Could we have a bit more ? 4) I have never once insulted or poo pooed the ability of American Paramedics. Far from it. They are the envy of the uncivilised world. I have only questioned the moral and ethical traits of the individual concerned.

What standart?, there is no standard in ems, and most of the guys I know who let their NB laps are from the private realm.

This is real fire based ems at it's finest 46, this is why these guys make $$$, and have a great pension.

Has anyone been watching First In, great show real hero's to say the least.

I know you have read my posts about how and why other professions have advanced their education and I am really puzzled that you claim to be pro EMS as a FF but can not seem to see them as medical professionals. If you do not want to advance with EMS then you really should consider if you only got the Paramedic patch for a few extra dollars from the FD for your pension and not for the patient care aspect of the job. Your posts lately have only been about what the job can do for your bank account and not what you can do for the patient. Even when you were talking about getting a degree as an RN or RRT in other threads, you mentioned very little about the job or the patient care aspect. Neither you or Diazepam618 are a credit to Fire Based EMS when you fail to realize there is a patient involved.