towheadedmule

My profound apologies Defib. R

Well since you didn't give your location, and I hoping for PERSEC reasons you did not put it on your profile, we have to surmise you are in NJ. Given that, have you tried to unionize? Are the cops vollies too in NJ? R

Goto your local National Guard Armory or Army Reserve Center. Army has been doing this for years. Just ask for the S-4 or the maintenance chief.

Sorry for the confusion Sir. I am always a fan of more eductation. I get a lot of the patch factory as student riders. I end up trying to fix a lot of problems usually. Its frustrating in the least to try and get them to understand the ISAL method when they do not understand the blood flow though, around and for the heart. One even said he didnt think was blood for the heart?!? Between that and his IV skills learned from a Singer Sewing machine and would not listen; well the supervisor came for him. He was barred from returning to our service for clinicals.

Not shocked at the job. Shocked by what is expected in class. After the spoon feeding of EMT-B, many do not really get they have to study to pass. Until we can pull the programs out of tech schools and into colleges and universities expect the same. As for the credit, it is not credit towards the degree. It is credit towards admission. Many of the local programs will not admit you to a nursing program without a PCT/CNA/LPN time (usually 6 months). It is used as a method showing that the person wants to be a nurse, and is more prepared to face the realities of the position. Foolproof, no. Rather like SF, no way you were getting in on your first enlistment. Changed now from what I understand.

I would like for potential students to have had exposure to different types of patients, not just the antique roadshow. Higher volume, better chance of different types of calls. They can see how different Paramedics handle similar situations, some good, some bad. I admit, this works better in systems with paramedic/EMT-B partners than tiered systems. Discounting any experience would in the field not be beneficial, the student has a better understanding of what responsibility they are accepting (still a shock for the vast majority). Even the Nancy's realize the importance of prior experience, giving credit for CNA time. YMMV R

it's my opinion. That is what was asked.

crud. Well like the gunny said I may not be smart but I will be strong. LOL.

Veteran status alone should not count, even medics. What classes they took as medics/corpsmen should matter. I find myself using my sick call screeners training more than my paramedic training on the streets. 18D, Independent Duty Corpsman, 8404 Corpsman, EMFB (any schumk can get shot at, EFMB is earned, not trying to downgrade the troops, but a purple heart is not a Go on life), Sickcall screeners (not sure of army equivalent). These are usually good additions to programs given a good R code. PJs I think are already paramedics. The Quad zero Corpsman that emptied bedpans at the Naval Hospital in Beaufort SC is not a good choice. as for FineArts vs Science.... Medical schools like Fine arts for physicians, why shouldn't we. Our former Clinical Coordinator at EMSA in Tulsa had a degree in Art History. Didn't make him less a paramedic. Might even say a broader minded one. Some Science majors are not able to articulate with patients who don't understand that cardiac history means the HTN and AMI. What about the person with an AA or BA in Spanish? Experience.... Higher for people in High volume services. Billy Bobs transfer service with runs to the nursing home to take Aunt Pootie back is not the same as 8-16 patients of varying acuities over a 12 hour shift. YMMV R

Its also in the book pathophysiology of Heart Disease. Its listed in the recommended reading list on this forum. Really good book, IMHO As for the thread, I always get a BP and pulse before I give nitro, but not necessarily a 12 lead or a IV lock. Usually the sequence is BP/pulse by fire prior to my arrival, determine need, ASA, 1 Nitro, meanwhile partner is attaching Lifepack while I do the line, 12 lead, time to determine need for second spray, move to cot/truck, MSO4...............rinse lather repeat... It works well for me. YMMV

My system runs one Para and one Basic for the most part. Sometimes to fill shifts management allows double Para trucks. Our contract with the City mandates a Para in the back of the truck with patients at all times. I find it to work fairly well. With the exception of IV, Intubations, Drugs and other advanced skills, My partners can do most of the others.Most calls are BLS calls anyway. But Vitals, assessments, thinking about what the PTs DX is and BLS interventions can be done by the Basics. And if it is a difficult pt that is taking up time with ALS interventions, then my partner starts with the paperwork. Call them teachable moments. Its about teamwork, quarterback may call the plays, but that does not lessen the importance of the offensive lineman. Then again, I am told I work in an odd system. I like it. Russell

I wouldn't know about all PUMs, of for that matter tiered systems. If I expressed that view my apologies. I should keep my opinions of Fire based EMS to myself. I do know that I don't hear a lot of sabre rattling at my system and in my division. As for the other division and services, I can offer no opinion.

My "basic" yesterday was the DirOps that started EMSA in Jenks. Made for a interesting day, giving me history lessons of posts, stations, corp HQs over the years. In the last 4 shifts, I have been with 3 different Paras. In the morning I work with yet a different one.

Dust, there were references to whether basic level or medic level was better. We don't have that argument many times in our system, at least not on a mass scale. There is some grumbling, But they don't usually last long. Some of the long standing basics know how to use the system to break a paramedic. No comment on the morality of this from myself tho. We do run a lot of double para trucks. They are not usually assigned to one another, more of ad hoc groupings dependent on the schedule for that day. It has more to do with the turnover in basic members (mainly a product of low pay). In the end, I care little for the color of patch on the arm, but rather the partner I have. Did we make it home, nobody died on the truck, had some fun and provided the best patient care we could. Did we learn anything? Sorry about not being more clear. R

Medics can be useful in other calls other than cardiac, contrary to popular belief. Pain control difficult childbirth (although I prefer a diesel bolus for this, especially when the 24 week preemie pops out on a G2P1AB0 mom with 25 second contractions at 10 minutes length!) the CHFer/COPDer who waited to long to call and crumps (had this call about 12 hours ago) crush syndrome (with the right protocols) anaphylaxis coma unknown etiology (O2/BGL/Narcan anyone) weakness for week with diarrhea and sucking down Tums to the tune of 6-12 tablets a day. oooh looky,,,,tall spiked t-waves in the precordial leads with absent p's in I, II, III Pregnant lady with a hx of seizures,,,,,valium or mag,,,,valium or mag....ARGH! all calls I have had lately My city's PD requires a BS/BA to become an officer. Does that mean they are better cops...no. Probably more rounded. Paid better yes. I look at ALS as a team sport, work as a team, live/die as a team. Still, there has to be a quarterback. I love working with basics. I guess the basic vs medic doesn't come up cause we are a PUM. Now Fire-base vs EMS based.......thats a different story! R

Not really sure you would want a white shirt...lol R

As of yesterday, the last run number I had was XXX35043 thats 35043 Calls 100% ALS assessed, treated and transported or released per their request.....with the vast majority being what could be classed as a BLS run. In fact I have run hot back the hospital with more non life-threatening dispatched calls than those with life-threatening dispatch criteria. To be fair, our system is completely ALS. We use basics on the trucks, and most are critical elements of the team. Some you have to watch like a hawk, but i have had paramedic partners that were the same way. The last statistics I saw for our system in my division was a intubation success rate of 92% for the previous month. We do not RSI, so only cardiac arrests, respiratory arrests, unresponsives without a gag, and with CPAP, the rare flash edema gets a tube. Anyway, I think that the basic premise of practice is good. I ran so many immediate actions drills in the service that i can still do, ie SPORTs on a rifle. You cant do a skill once or twice (even in a year) and consider yourself proficient when placed UNDER stress. Its muscle memory. You can read all about in a book called On Combat, by LTC Dave Grossman. Yes it is mainly about combat, but much of the stresses he refers to is applicable to EMS. Well worth reading, if for no other reason to understand some the actions/antics/concerns of veterans. YMMV Russell

There used to be a company here, not sure if they are still in business or just not coming to our hospitals, that wore neon lime green t-shirts. The one group I saw was almost morbid obese, shirts untucked with blue jeans and work (not duty) boots. Heck, one even had holes in his shirt. And this is/was a paid volly service. and yes I get they personel reference. It caught up with him.

AAAHHHHHHHHH!!!!!!!!!!! you said the word, THE WORD!!!! better to say Voldemort than that name. then again, I have some of the old patches left Personally I am glad for new management. 8)

We use a white class A shirt with either 6 pocket EMS pants or 4 pocket trousers. I prefer then 4 pocket. I think they look more professional. We are supposed to wear either a leather belt with a brass buckle or a velcro belt. I don't; I use a rigger's belt, mainly due to the extra security it provides in retention, more comfort, and can be used in a variety of ways for field improvisation. Oh, and we have badges and collar brass. Russell

Yes, your FTO is one of the better ones, prolly an oversight. There is just so much to show/teach/eval with little time to do it in. Track me down and I can show you, or some of the older EMTs or Paras can.

I don't see it as a ego and/or wanker issue, more of personal preference. Like gloves, or cars etc etc. As for the safety issue, I had a partner that after 6 months working together still managed to dump me 4 times in the back in one week. (And no I could not talk to her about it, nor change, due to other issues). I just don't like bouncing in the back with loaded paddles. It is nice that Almost all the fire guys either use the LP12 (ALS) or have compatible pads in their AED (BLS); furthermore, we have 6 hospitals and all but one have compatible pads. PS the navy jerk was not a darwin, but grand champion of the Moronic Secret Society. He is the only guy i have ever known that needed to crossdeck from ship to shore for an extended stay to remove a particularly robust strain of an STD acquired from an adult fun street vendor.

Actually your FTO was supposed to take care of that. However, given that education is adding more to he FTOs workload it is not surprising that is overlooked. That and the 4 sets of pads on the truck (2 in the bins, 2 in the LP) you shouldn't even need the paddles. They are there because the state requires them. Also, don't forget the LP12 can be used as a AED. Nice to know when you are working alone in the booth of the State fair and someone collapses a few booths over. As for the thread, I prefer pads. I feel that they are safer. I watch a guy in the Navy stick the paddles to his rear and charged to 100j. Didn't sit for a week. Lesson learned was never leave a boed 19 year old with defib at 0200. Althougth there is something to be said for shock at 400j and give 2 amps of bicarb! R