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Actually, public education should be an important component of EMS. Injury prevention, public outreach, public health issues, disaster management and other areas are important and working in the "field" gives us unique perspective and can allow us to being said perspective to the public. If anything, public outreach is sorely lacking in the United States at least. This may be as simple as teaching CPR and first aide courses or complex as working with the public to develop a comprehensive community disaster plan.

Seeing the pictures made me really cringe. I wish I could have been there to help. From an EMS response standpoint, here are my thoughts: - The prevalence of lower limb injuries is interesting. This could just be by placement, but it may have been by design as well. - I'd really like to see the PTT/INR stats on some of the victims. Bad guys have been known to pack the shrapnel with warfarin containing pesticide to increase mortality rates. - Hats off to Boston EMS. Wow. Great job. The response will become required MCI reading in the future. - This is the MCI eventuality that a lot of us have trained for and hope would never happen. I hope that it will reinforce the importance of training, preparedness, and preplanning.

So.... As you begin to load this guy onto the cot via "Slide yourself over buddy"... He suddenly voids his bladder in his pajamas. "holy Sh*t, I didn't even know I had to go!!" He is super embarassed, and swears he felt nothing... he just sees the urine and puts 2 and 2 together.

If you read the requirements for recertification at www.nremt.org, you will see that you must be actively working where your ALS skills are being utilized - it doesn't specify where. Are you using your advanced skills while working outside of the US? If you satisfy the requirements, will your medical director sign off for you? Be actively working within an emergency medical service, rescue service, or patient health care facility using your ALS skills. Complete all requirements prior to March 31. Complete the recertification report in its entirety and submit the completed report prior to March 31. Demonstrate continued cognitive (knowledge) competency through continuing education or examination. If you recert by exam, how many chances do you get. ONE Exam Option Certified EMS professionals may make one attempt to demonstrate continued cognitive competency by taking an examination (in lieu of documenting continuing education) within six months of their expiration date (October 1 through March 31). As I mentioned, all of this can be found on their website. Toni

I work in Dallas for a private service, and I'm an EMT!