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So... Explain this to me. We're in the ambo, going toward ALS, providing the Stare of Life. Driver yells back "30 years ago, we'd start rotating tourniquets"...and on we go. Throws stuff out like that from time to time. Explain to me "Rotating Tourniquets"..and go.

On the boards one frequent thing I see arise is our pay and lack of respect. I personally feel among the new trend in short cut to education (yes 6months accelerated program to paramedic is a JOKE) and the lack of professionalism. I sad trend I see if folks who want to play hero but want to live it. I agree with Everyone here if your a 300lb medic you better be 7ft tall, and that goes for the rest of our fellow public safety brothers. The public hold us to a higher standard and if you dont like it please leave there is plenty of work for dedicated professionals. Your uniform says plenty about you if it is covered in stains and worn you look like a SLOB and I dont want to hear your crying about "well my service only give me X dollars for uniforms, The Army as of 2011 currently gives enlisted personal 1,400 male and 1,600 female initial uniform allowance and I can assure there KIT cost allot more yet they maintain exceptional uniform standards in much hasher conditions. The way you dress and carry yourself speaks mountains about you and who you are. On a recent assignment I had the pleasure of working with someone from this very same forum and we became friends quickly. I asked him once why he felt I was different and he said " your not always telling BS war stories and you act professional" and that my friends is the secret to respect. The more we dumb down our standards and make it OK to be 450lb pound EMT the more the Doctors and Nurses will look down on us and keep our salaries in check. I would love to not have to always take contracts in harms way and away from my family, I dream of a day when ALL MEDICS need a 2 year degree and I can earn at home doing what I love and able to take care of my family . Sadly as I look online I see another 1 year 100% online medic program and watch as a officer I work with referes to a EMT as an ambulance driver and comments on his untucked polo/ with shorts and black sneakers I am realizing we are heading backwards in a profession. The ones who won't Iron probably are also the ones who can't check there drug boxes and always need to be reminded to certify at the last minute too. 5.11 are very professional if worn as you said well.

I have little knowledge of CPAP devices, I do, however find the "hurricane of air" tagline pretty weak for a device that is supposed to be used by medical professionals. "Hold on a sec miss, just let me prepare this device so I can treat you with a Hurricane of Air (as the scorpians hit Rock you like a Hurricane plays on in the background). I did treat a pulmonary edema pt the other day, but she responded well to Nitro, so I have still yet to give the prehospital CPAP a test drive.

Ugh

Simple idea, here. Accelerate the cleaning and polishing from once a week, to as needed, even if this means daily.

Richard B the EMT I see a "Fail" here, but I can't point fingers. Yet. Well I do and I LOVE NEW YORK CITY cause no BS ! Agreed and quite embarrassed actually, but why ? That is because I voted to re title EMT and/or the P1 (in BC) to PCP with Paramedics Association of Canada (that was 16 years ago) and here we are today and now a "PCP" cannot interpret a farking lead 3 ECG first degree block and admit to this on an international forum for EMS professionals ? <insert head slapping noise> Well I guess I failed so many years ago to believe that "what was accepted at that time in Alberta was the standard Nationally" so FAIL SQUINT bad, bad SQUINT ! And here and now the Ontario PCP are most likely better at interpreting a STEMI that I am. I FAILED to recognise that the government(s) would prostitute this title to cause less confusion I was so wrong .. I have allowed the general public to be under an illusion that when a truck has "BC Emergency Paramedic Ambulance" on its side but does not have an ECG that can not display a rhythm is simply terrifying for the future of Paramedic profession, btw PCP "nitro" is in actually your scope of practice too ... you know just in passing. Major link worth reviewing. http://www.paramedic.ca/Content.aspx?ContentID=4&ContentTypeID=2 Link to competencies. http://www.paramedic.ca/Uploads/Area%204%20Assessment%20and%20Diagnostics.pdf Link to medications lists. http://www.paramedic.ca/Uploads/Appendix%205%20Medications.pdf rock _shoes: Sorry man no mercy here on this stupidity and bring on the negative reps from the politically I should be more correct crowd. I feel a complete shred just maybe tough love is what is needed here as a tune up, yeah think EH ? no LOL at all. So Best Advice their BC PCP: READ and EDUCATE yourself before continuing to embarrassing yourself and MY country, YES see above rock_shoes is 100% correct, interpretation of basic ECG rythum's is a National standard for PCP, first degree block is a basic arrthymia, therefore logic dictates that you are sub standard please pull up your damn socks. Agreed absolutely no excuses allowed, I believe some ripping is needed too ! This in Kanukistan is a legal responsibility called "due diligence" or in fact criminal negligence so FAIL HUGE besides as rock_shoes states there is an 110 inverter on board that truck, or was that broken ? ps BCAS is damn near completely standardized in every unit throughout the province. Excellent point(s) Dwayne an unwanted and unneeded adrenergic response, (ie Adrenergic means "having to do with adrenaline (epinephrine)and can lead to a fast heart rate this is called tachycardia and increasing myocardial oxygen demand, btw Dwayne that explanation is not intended for a pararescue ninja. Now one shot of nitro pain resolved chest pain with elevation in STEMI and an elevated "TROPONIN" level, and transported with an RN, BC is such an interesting place. No information provided in this senario indicates any life threatening distress, the patient is NOT in extremis and to pick it up L+S .. well this just increased your speed and statistical increased incidence 20 % for an MVC is that a good practice ... fill in the blank. Disagree ... an absolutly Stupid Rhetorical question did PCP ever ask the RN if L+S was required ? PCP do some "thinking" and "personal research" on the terms you wish to quote BEFORE asking questions because this thread is exactly that, rhetorical. You have failed in every thread where I have taken my efforts and sometimes extensive amount's of my time invested in YOU to be polite and educational, unfortunatly you have yet to answer one basic question, don't believe for a second that this culmulative effect speaks volumes. FAIL in legal knowledge and understanding of your scope of practice, and pure observation, that being that cold, clammy and pale says a lot about a DX when a patient is complaining of Chest Pain, you don't need a machine to tell you someone is circling the drain and needs diesel bolus. . So ok teaching point just what was the underlying ventricular rate ? You are trained in taking pulses as a PCP aren't you as that would be a vital sign or perhaps look at the pulse oximiter reading, also scope of practice, so normal B/P ? hmmm .. so why am I getting an impression that we are talking with an OFA level 3 ? So If this patient died when under when your care and in your truck (no matter the RN present) you would look the fool @ fatalities enquiry, possible criminal negligence as well. Did you write a PCR report with no information on it too ? this is absolutely no joke, EH ! Wrong answer the RN stated and again you are as responsible for that patient's condition and knowledge of vital signs as the RN, you must perform to the level of your training, period, and only if you had an MD or ACP on board assuming responsibility written and signed would you NOT get slammed in a "shotgun legal suit" just saying. Good job something learned, you can have a non STEMI and have elevated troponin levels as well, just because one has elevated ST segments does not "absolute indicate" that one is having an MI, a prior Bundle Branch Block would be one of the exceptions. TROPONIN :http://en.wikipedia.org/wiki/Troponin_test When chest pain via SL nitro relieves chest pain, this is typically be called angina, now if the call went well all in all then why generate a question ? Should I mention I am trying to quit smoking, nah that would just be an "excuse" myself for being pointed and opinionated and have pride about my profession as a "PARAMEDIC". cheers

Professional appearance: Clean, well fitting clothes, and professional demeanor. I could care less if you're wearing a polo shirt, a nice T-shirt or a button down... and I'm telling you, you could be the purtiest damn medic in a button down and if your medicine is crap and your behavior sub-par, I'm not going to be impressed in the slightest. My SAR button down is actually a hunting shirt with patches sewn on it. I need to find one that fits me better, mine is way too big (that, or get the one I have tailored.) My more informal shirt is a bright orange T-shirt or a navy blue T-shirt with our patch screen printed on the left breast. I'll tell you what I know I look better in and am more comfortable wearing... the T-shirts. Does it fit? Can you move in it? Is it clean? Are YOU a professional in how you comport yourself? Awesome... carry on... Wendy CO EMT-B

quite a few medics I'd like to see in a bikini top and thongs for a uniform... just saying

I think you're getting a little tunnel visioned based on a complaint of chest pain in a cardiac patient. Not all chest pain is equal. I would also most likely not have upgraded this call, but I would have ripped someone a new asshole, myself likely, for not having charged batteries in the monitor. As Fiz said, she needs an evaluation, a new one, as she's not in the same state as when she was picked up. But if the pain resolved with treatment then I don't see any reason to get froggy here. You need to also consider that though you might save a few minutes with L/S, what are the physiological effects of those things on the pt that you believe may be having a cardiac event? Lots more info necessary to decide, but as you can see, the overriding majority are against. Good question though! Dwayne

Dont take this the wrong way, but have you considered the fact that "you" may be the problem. Are you 100% sure that your resume, speech, and body language do not amplify your negative attitude towards your present career ? As someone who has done the hiring, I can promise you that it is fairly easy to spot the "negative" folks who will sap the life out of your organization, and I wouldn't hire them no matter how desperate I was to fill a schedule. There are professionals that you can see to help you improve your resume and interview skills. If you cant afford it, you can go to the library and get books/audio-video materials for free. Of course, it is easier to blame the employer, the county, the Fire Department, the State, the industry, the economy, and the vast secret political organization that is conspiring to ruin your life; but as long as you stay in this "internal rut", you will always be this miserable. 99% of attitude is about how you respond to adversity, not what adversity does to you. Maybe it is time for a total career change, or atleast a location change; the last time I checked, Florida interstates do not have any barriers that forbid you from driving out of the state (except the toll roads lol). Right now you are in "victim" mode, your life will not change until you change that.