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If you would have understood the post you would have seen where I noted that the redness resembled his mesh undershirt. He had several layers of clothing on and I'm sure was a little chaffed in more than one area after sweating all day. Also, he never complained of pain, only of a "tired" feeling he noted was more than likely a result of riding his bicycle all day. I did palpate the entire spine. The medical director has since found that I did not err in my care of this patient. Nothing is "plain and simple." I wouldn't immobilize a nursing home patient with a compression fracture when it's been treated and I'm there for another reason such as a routine transport. Perhaps it's all cut and dry in your world, but in my world all my patient's are different, and I treat them all differently. Thanks to everyone who had valuable input.

Maybe their the fentanyl lollypops? Otherwise I've never heard of this. I'll pop it into pubmed, but I have my doubts. Edit: I'm surprised as heck to say this, but I found a reference to glucose as an analgesic. Will keep searching, but for now look in the results section of this abstract. Edit 2: Very interesting indeed. Take a look at this abstract. Makes me wonder what the underlying cause might be. My current off the cuff thinking is that the glucose plus pacifier technique has more to do with enhanced distraction than an actual relief of pain. Still useful though. The search continues. Edit 3: Clinical guidelines for glucose analgesia. Edit 4: Maybe I should save these up, but I keep intending to go out the door and google keeps distracting me with more tidbits. Apparently glucose does not act on opiate receptors, as naxolone does not affect it.Read here. Hypothesized in another study that the relationship between glucose and opiod receptors is indirect and that glucose may result in the release of endogenous opiods.

1) Series observation- I know of no helicopter that is that quiet while doing a "Hot Load" (loading while the blades are still turning, if memory serves me correctly), or even on the inside during flight. 2) Would YOU be looking for a live turkey to be killed for you, while on duty and in uniform? Going to put the bird into a side compartment during the tour? 3) Tyler and Boone discuss Turducken, a mix of turkey, duck and chicken, as alternative for a turkey or ham. While I've heard of Turducken before, the concept is so...yuck...I wouldn't partake of any. 4) Rabbit turns down Marissa's invite to meet the "wild cousin"? WTF? 5) Putting a frozen turkey into a deep fry cooker is not recommended, as indicated by the resultant explosion. Also, on some Food Network show that was on in the restaurant I ate at a few days ago, I was informed that the Underwriters Laboratories safety people refuse to give any sort of safety rating on any deep fry cookers. 6) Must be local protocols, again. I'm restricted to 1st, 2nd, and 3rd degree burns, but have been told not to use any reference to a 4th or higher degree burn. 7) Tyler has not mentioned to his folks he's gay. I wonder if they'll show a family reunion when he does? 8) Rabbit again try's picking up the intern. Interesting line she uses: 9) Nancy uses visual and touch to diagnose a torn meniscus? I had to fight for the NYC law department to authorize an MRI to determine mine, as it doesn't show up on regular X-Rays. Does that mean Nancy is actually Superman's cousin, AKA Supergirl, using her X-Ray vision? Also, "on the count of three", reducing a dislocated knee (actually on the count of 2!)? 10) I like that cultural line of a thin red thread tying soul mates together by the ankles. I wonder if my Lady J and I have something like that, even though we're neither Chinese or Japanese (I'm a Russian-German-Polish American, and she's Sicilian/Italian American)? 11) Rabbit seems to revert to character, and accepts the date with Marissa's cousin. 12) The captain yells "Everybody, Wait!" to announce the impending MCI of the plane crash? Possibly realistic. 13) Alameda Naval Air Station must have different protocols for jets without landing gear down than JFK. No foam on the runway as a lubricant and fire retardant for the crashing aircraft? ( Going by memory, I really don't know of they do that at JFK, either) 14) For an active Naval Air Station, I saw neither sailors, Marines, or any security placed on the SFFD personnel, while they were on the military reserve. 15) I restate my liking of the colored tarps for assisting Triage. 16) Rabbit and Nancy get into what I know as "Proximity Suits" to actually get into the burning aircraft to perform the search for the baby's mother. I donno, wouldn't Fire fighters do that, and bring the body (or corpse) out to the paramedics? 17) Mommy defibbed twice, and immediately allowed to sit up and hold her baby? I don't think so. 18) Can anyone in the military advise me if they'd allow a civilian aircraft to make an emergency landing on the reserve? It was too quickly done, as I see it, but I don't know how it works in the real world. 19) Of course, Boone invites Tyler to dinner. (Anyone else notice Boone didn't advise his wife he was bringing one more to dinner?) 20) Rabbit goes against type to blow off the date with Marissa and cousin. 21) It telegraphed itself that Tyler would use Boone's family for rehearsing how he'll eventually tell his own family he's gay. 22) Rabbit just shows up at Nancy's family dinner, and gets invited in. Real or Reel life? 23) It seems all the regulars ended up with some kind of Thanksgiving dinner, even if Glen and the Intern just have turkey sandwiches. 24) Rabbit and Nancy kiss. I guess the writers are going to keep us in suspense as to what is going to happen to this couple. Is that a thin red thread binding them at the ankles?

http://www.mdcoastdispatch.com/article.php?cid=30&id=7560 http://firegeezer.com/2009/11/27/lawsuit-dismissed-no-special-relationship/

You stated that he had obvious redness to the lower thoracic spine, but you only note that he had no tenderness to the c-spine. To exclude a patient from spinal immoblization you must palpate the entire spine, not just the c-spine. Any complaint to the spinal column requires spinal immobilization. Plain and simple.

I would have to say that you need to focus on things outside of the clinical realm and get a good dose of experience out there in the big wide world. My experience has been that the ambulance service (here at least) looks at you as a person and not what you can do medically. While that is important it can be taught. You can't teach maturity, life skills and how to get on with people.

Well, it'll be more urban based due to my locale. It will cover as many agencies as will allow me. You nailed it with the last couple lines though. It is meant to portray what happens behind the scenes I suppose. Just the physical, mental, emotional, spiritual, and financial toll it takes. My ultimate goal is to provide the viewer with what our lives are like. It will span months of footage, personal stories, spouse comments, etc.

Need more details- like the original call, how many victims were there initially, what were the signs and symptoms, etc, but, based on the passage... I hate to say it, but if they knew or even suspected the patients they had were CO poisoning victims, these medics DID screw up- at least in a procedural sense. Anyone else in that hotel(or at least in the immediate area) were potential victims as well and that place needed to be swept for CO. That hotel should have been evacuated. This was a hazardous materials incident and needed to be treated as such.

It's for the select few of use that are on the naughty list. We are a elite group with a very stringent selection committee.

I love how chastising other nurses for not doing their job is "proof" that he was overdoseing patients. If that was the case, Im a serial killer! I don't know this, but I read between the lines a Nurse (who used to be a paramedic) who didn't fit in with "traditional nurses" clique (probably because of his "paramedic" upbringing and attitude) , rubbed them the wrong way, and now became a target...but thats just me. Seen that before with some medics who transitioned over to the other side.

For the long term.....BSN is good. Business management with an MBA tract is even better, or a management degree with a focus on health administration. A masters or a doctorate in public health is good too, but not for staying in EMS/Fire. But honestly, for the short term....try just getting you core courses for a BS out of the way, with A/P and a language for the short term. Seriously, TAKE a language..and not just a semester...LEARN one. A lot of people like Spanish, but in our area French is almost as valuable (lots of French speaking Africans), and German is good too (Bosians, Serbs, etc usually speak some German) Here's a secret: Your education credentials may get you the interview..but YOU get the job, not your resume. Get some life experience that is valuable to your employer, such as language, travel abroad, internships with social services type of work..the military, anything to make you stand out from the hundreds of young 20-something wanna be firemen/wanna be heroes out there who have only done EMS or hung around wacking off to Rescue Me/Back Draft and nothing else.

"Somebody's gotta tell her she just lost her husband." They seriously need better writers. "Ya just did, Probie!" Should've been the next line. It's a good thing I'm not on the set. I'd be yelling, Cut! Cut! Cut" Until they fired me. Like when Rabbit put the pen in his mouth in the ED. Pens are the most radio-germo things we carry around. Never mind putting one in your mouth. "I saw some of you guys laying him on the black tarp." We can all see the "fail" in that setup. Wasn't triage a bit too close to the still burning airplane? The boys at Alameda Field are crying the blues now like us, because yes, they have real foam and stuff. The writers blew another comeback line . . . "I'm Gay." He says to his partner's family. Next line should've been, "Pass the carrots." A couple of scenes rang true. The elderly lady from the plane crash. Comforting her in the back of the rig, listening to her go on about her family, we do a lot of that. I guess everyday is thanksgiving where I work. Blondie listening to doctor dad and brother talk about an ACL operation like it's a golf shot rang true. She's disgusted by them both as she sees the dirty side. "So what are you?" "I'm . . . not going." The writers missed taking a chance here too. Rabbit is a Māori from New Zealand and they could have gotten a whole thing out of that. I am impressed they set the clock correctly on the monitor. It read 1527, and their shift ended at 1500, which is just when the plane crashed. Go Rabbit! Looks like VT to me too . . .

http://www.nyhealth.gov/nysdoh/ems/certification/reciprocity.htm Click on the information packet for NYS EMT reciprocity. You'll be much better off completing your medic program in NYC or NJ. Ride alongs are on double medic units, who only get ALS call types, a large number of them. Compare this to other areas in the country where the ALS units run everything. Time spent on medic unit ride alongs need not be wasted on calls that aren't challenging your newly learned knowledge and capabilities. Outside of NY/NJ these units only get true ALS calls that are few and far between. Instead, you'll be running a bunch of minor injuries, psych pts, sick calls (may be something more, but not likely - always do a full assessment), drunks and such. Not that these pts aren't important, but you ought to have more of a challenge during medic ride alongs. In NY/NJ a typical 8-12 hour rotation will produce a cardiac arrest or two, a CHF pt, critical asthmatic, maybe an MI or two, unconscious/apneic junkie, multi-trauma, etc. You'll have at least 2-3 good jobs per rotation, maybe more. No exaggeration. Just pull rotations in the rougher parts of B'klyn, uptown in the city, most of the Bronx. The learning curve will go through the roof. Many of these medics aren't degree medics, however. You decide if they're good at what they do or not.

Unless you attributed the 'tired feeling' to a neurological deficit, which it certainly sounds that you didn't, I wouldn't have immobilized this pt. I just had a like conversation with my medical director after clearing several pts via NEXIS and then having the ER freak out and immobilize based simply on, in my opinion, "key words." As you mention, bicycle/auto, auto/telephone pole, ped/auto, etc. In EMS you certainly can't judge a book by it's cover. I asked my Medical director, "Does there come a point where getting along with our rural hospital is better for my pt than attempting to do more progressive medicine?" His reply was, "No, there doesn't. You explain your reasons for your choices, if they don't understand then educate them, if they still have issues they can complain to me. You, in no case, choose regressive medicine to make someone, anyone else happy." I wanted to kiss him on the mouth. Assuming this pt had no drugs/alcohol on board, was mentating properly, then I don't see any indication for immobilization. The words bike/automobile in the same sentence do not trump intelligent assessment. Not ever. Awesome question, and responses. Dwayne

DO NOT use the nebulizer with less than pure spirits. If you absolutely must, use high grade vodka. You will be significantly impaired before you get much in your system, and the hangover isn't quite as bad.

Follow your dream not your dollar! I just gave up $150K/yr cause it just isn't fun being miserable with money when you can be happy with a whole lot less! A well travelled RN or Paramedic is lot more valuable than a cranky one that has been in the same place forever!

ROFL @ your signature! I'm assuming that you are fluent in Spanish, right? If not, there are quite a few schools in Mexico where you can spend a month or three living with a host family, and getting intensive Spanish instruction all day long during the week. Some even have programmes to get you time in a hospital or other medical environment to learn medical Spanish. Many I have spoken to say that it will get you native fluent pretty quickly. It's something I always wanted to do. And you'd certainly get a great opportunity to check out how things work and do some networking while you're down there.

I think you are misunderstanding my original post. Actually by what you posted it looks like you did not even read the original post. I know the interview and your social skills land you a job. I just want to know what I can do to make my resume get me places.

Ok call me crazy to respond to the OP query: Would you not have to be the Ultimate Paramedic to Have the Ultimate Paramedic Resume ? Following that concept a degree in Business may be the objective if one wishes to become a manager ok fine, but in patient care would not a degree in Sciences be the goal, yah know like paramedicine ? Seriously: There are some on this website that would wish to climb the corporate ladder and the other's that are quite content to be just damn good Paramedics FIRST. cheers and good luck with that.

Stretcher shoulder straps may stop some movement in some accidents, but I having no expierence with them can't imagine treating a critical patient with them.

Confidence.

That's right, I forgot. What happens in the hospital is sacrosanct and perfect. It's EMS that are always the screwups. Right? One form for the whole state. It doesn't even happen that often. Not hard to keep track of. And part of the charge nurse's job. Yet some of them have utterly no idea what we're talking about.

Hey guys! I am trying to build the ultimate resume for a Paramedic. I want to be able to put my application in anywhere throughout the nation, and land the position I want, due to my stellar resume and experience. At the moment I am an NREMT B with a general studies associates degree. Most of the Medic courses offered around me require you to be a basic for at least 2 years. Since I will have some time to kill before I can apply for Medic course, I was wondering what the best 4 year degree is to go hand and hand with an NREMT. I have heard a lot about degrees in Management being very helpful due to the fact that EMS and Fire are extremely hectic worlds always looking for some organization. So what do you think is the best 4 year degree a Medic could hold to better his position, pay and life. Thanks for you input ahead of time -Derek