Riblett

To the dad,

"Hmmm....he doesn't look like you very much does he?"

Wow Mateo that is great...when I am bored I sing "Tenormin-Atenolol, Tenormin-Atenolol, Tenormin-Atenolol"

To the tune of Hakunah Matatah

Better As A Memory-Kenny Chesney

Around Here-Counting Crows

You make a great point Mateo. I can see NC's Community Colleges being free to in state high school graduates as positive thing, but with the stipulation that they maintain a certain GPA. And clean criminal records; the first drug conviction a student gets should be the end of their free in state Community College attendance. Period. The last thing the college systems need are those getting a free ride who are ungrateful and put forth little or no effort.

I actually did try talking to him first, even apologizing for my choice of words. That got me no where. But it did make it apparent that me staying on that unit would not be beneficial to either of us. So I wanted to talk to my clinical coordinator, before anyone else did.

I see this sort of behavior a lot, as a student and at my own agencies. I have rarely been the target, as I try to walk the fine line between maintaining my dignity in the role of "the student" and flying under the radar. I see preceptors being unprofessional or even downright mean to "the student" or "the recruit", to which they are so commonly referred as. It says a lot if they can't even be bothered to know their name. Many preceptors are being forced into the role prematurely or unwillingly. And it shows. Besides that we as a culture in EMS encourage or at least tolerate this sort of pseudomilitaristic treatment of new comers. I understand that there should be a reasonable weeding out. But I see preceptors who were treated this way while they were in school and continue the behavior down the road, because it is all they know. We need to remember that we were all in their shoes at one time. We are all a team in the field and so should we be in and regarding the classroom.

On that same note, it is worth noting that we are in a profession that forces us into teaching and command staff roles earlier than most. Paramedic schools (especially ones consisting of a college degree) need to place more emphasis on leadership, management, teaching, and just general "getting on with folks".

Couldn't agree with you more Dwayne. And now that you opened that can of worms:

Seems that the harder I work, the less help I get. Maybe I should have a few kids all with different "baby daddies", quit my job, get the state to pay for all my tuition and books, and give me child care vouchers, food stamps, and welfare. Hey, it is what half the students in my math class this semester are doing, and they are proud enough to talk about it in class.

Maybe I am a little bitter, and am sure I will be labeled as such. But it a little irritating to see them talk about their childcare vouchers and tuition assistance crap, while they sit in class in their new brand name clothing/shoes, with their brand new textbooks, which they proudly did not have to pay for. Meanwhile I am sitting there in my uniform, coming to class straight from work, and knowing I will be eating ramen noodles and PB&J for the next month so I can pay for my used textbooks.

But as a small consolation, it was really funny to see their reactions when I walked into class the first day coming from work wearing brass and badge. But oh well, I graduate this semester. Such is life.

It seems that we are in a transition period where many paramedics are reaching for that degree, which is definitely a positive thing and advancement to the profession. However, the financial aid available to paramedic students is very little in comparison to other health care professions. Couple that with the fact that so few paramedic students are living at home with mommy and daddy. Most of us are paying for our tuition (and books-ouch!) ourselves working nights and weekends as EMTs. Community colleges are becoming less an less affordable and with the economic situation, student loans are more difficult to get and more expensive.

http://wral.com/news/state/story/2924399/

This is a cause for concern among the EMS community, especially at a time where we are trying to encourage degree programs among paramedics. The school featured is one of the few colleges in NC that offers an Associate Degree paramedic program. For most of us, a bachelors degree seems a bit out of reach, especially with starting salaries less than 40K. Paying back 4 years worth of student loans on a starting medics salary seems daunting.

Googling reveals lots of scholarships for other healthcare professionals, especially nurses, but few for EMS.

Really you don't need the O2 bottle. Forget it. Unless you are in a rural area and on a squad where it is common place and needed for EMTs to respond from in personal vehicle from home, with your own equipment. Even then you'd make yourself out to be a bit of a wacker.

Great advice Mateo, and stop me if I sound catty with mine. One thing I want to add, and there are those who might disagree, but just because you are a student does not mean you have to take crap. Your preceptors are professionals, and should conduct themselves accordingly. Over the last two years my experiences in clinicals have been overwhelmingly positive. But I had one paramedic who was really rude to me, cursed at me over something trivial. And I got mad and told him he was being an asshole. The jerk made me ride up front on the next call, and he did all the skills. I called my clinical coordinator, who called the lieutenant and had me moved to another unit. Not the most excellent choice of words in my response, since for several weeks I was referred to as "that (insert college name here) student who called (insert asshole medic name here) an asshole." But hindsight is 20-20. Not suggesting you follow my vocabulary, but you should not have to take crap just because you're "the student." You are a person who is there to learn and gain experience. If you have an experience like I did, follow the proper channels and report it. This whole 'eating our young' attitude among EMS preceptors has to stop.

Mateo I might have known you would spar over something like this.

Hmmm...how cool. I want one that looks like Elliot Stabler from Law and Order.

I had the experience of the Welch-Allen monitors a few weeks ago. A service with whom I was doing clinicals was testing them out. Working for two different systems, both using very different equipment I don't consider myself wholly oppositional. I tried the new one out with an open mind. I hated it.

The housing was so poorly designed that you had to practically take the machine out of the case to reach the defib button. There was no good way to put the cables in to where they don't get tangled up beyond all reason just by taking out the pulse ox (which we could not get a reading on the entire day).

Out of the 7 patients we put on the 4 lead, had only 3 of them that would pick up a rhythm and 1 of those showed a rhythm for about 2 minutes then lost it. The process of doing a 12 lead is long and ominous and the printer jammed continually.

Has anyone else used this brand monitor and had better luck?

An excerpt from an email to my supervisor:

"There comes a time in the life of every class A uniform, where it has lived a good life, having experienced every wrinkle and stain known to man. Remnants of Salsa Fresh, midnight Dr Peppers, coffee, blood and even the occasional lipstick on the the collar have made it the ominous evidence...nay, the proud show of devotion to the EMS lifestyle.

And mine has reached that point; it should take its rightful place in the far end of my closet to be taken out only when I wake up at 0500 to find the rest of my shirts are crumpled in the hamper."

Anyone who has been in this profession for any length of time as an ALS provider has had their first Narcan experience. We all laugh about the first time that we 'woke em' up' and the subsequent beating we probably received from the patient. In school the teacher will tell you to push it slow and only what you need. But it is not until you have that experience as the new gung-ho medic or intermediate that you vow to never make again.

Read mine, share yours, and special attention to new ALS personnel.

As a brand new EMT-I, I was called to a unconscious person at a nursing home. Arrive to find a 70-ish year old lady slumped over in her wheelchair, barely breathing and snoring with every breath. Has history of dementia and metastasized lung cancer and I suspected she had over done it with the pain pills. Having heard everyone sing the praises of Narcan and seeing Bringing Out the Dead one too many times the little orange box was practically screaming at me.

I slammed 2mg and she woke up-boy did she wake up. By the time we got to the truck she was swinging and trying to jump of the stretcher. Stupid of me to bring her out of her analgesia and back into the her world of pain and dementia that prevents her from communicating or understanding. The whole 45 minute ride the hospital I regretted that Narcan and was contemplating Versed with every punch I ducked. Now, I give enough to fix the breathing and no more.

It seems that these abdominal compressions would cause extensive risks of vomiting and subsequent aspiration. It might be beneficial to restrict this compressions to post intubation resuscitation efforts.

I think that, despite the obvious benefits to the patients, long time providers and even less liberal medical directors would be resistant to implementing the change. Not to mention the five to ten years of research and meandering it would take for AHA to change the guidelines.

This past summer we had a 3 y/o girl somehow fall down into a street drain while playing. I am still not quite sure how she got in there, and the cover was off when we got there when bystanders had tried to get her out. It was the kind that is up next to the curb and only half covered. (That is some great urban planning by the way!) But what made it especially difficult was that she fell feet first but her right leg was up next to her head and one of her arms was behind her. They say kids bounce, and this one wound up with nothing more than her hip joint being dislocated and a few scrapes from the concrete.

I am not sure if this is an early sign of burn out or not, but I have begun to somewhat avoid those who are not in EMS or at least public safety in general. They just irritate me so much lately. I have not problems with patient care or my co-workers. But dealing with friends of mine who are in different fields is no longer an enjoyable social activity.

I was having a drink with some friends, who are not in EMS, last weekend. Well one of them was trying to get me to tell him some 'cool stories' and I had the urge to throw my Appletini at him. Is that bad? Has anyone else experienced this? How did you deal with it?

One of my co-workers worked up to her eighth month. She had some cheap blue Dickies that she bought from Wal-mart and just took them to the taylors to sew in maternity panels. I am not sure what your uniform shirts look like, but if they are class A's Galls makes the button down maternity shirts on which you can put your normal patches and brass. They are made to be worn untucked and will cover the pregnancy panels in the pants. Our agency made a special dispensation for her slight uniform modification.

Shortly after entering the field of EMS I developed a latex allergy. If I have an exposure I need diphenhydramine pretty quick and the one time I managed to breathe in the powder from latex gloves I had to have an albuterol/atrovent neb too. It is usually no issue since in my own agency we have NOTHING latex on the trucks, because it all got taken off when the agency realized they had two employees with latex allergies.

But as a student it can present a problem with riding with other squads in the area or during clinicals at the ED. It gets hard because they don't always know what is and is not latex (funny considering patients have allergies too!) Some of the mannequins at school are latex so I have to wear gloves during class scenarios. Many of the sterile gloves in prepackaged medical procedure kits are latexm, but I just put on a pair of nitrile underneath.

Fall...90% geriatric.

Sick Call..mostly geriatric and can be anything from cut finger to constipation.

Chest Pain...very common.

SOB...cause everything that does not fall into the other three gets EMDed as breathing difficulty because of the EMD card system they use. Even if the chief complaint is toe pain if they are even thinking about having trouble breathing it is dispatched as SOB.

Well, lots of my co-workers had to quit smoking this year because the medical director outlawed smoking at all hospitals and EMS stations. Lots of people have had great luck with the Chantix, with minimal side effects. They were handing scripts for it out like candy over the summer for EMS workers.

Another one of the female paramedics went to a chiropractor for smoking cessation treatment and she stopped cold turkey, after smoking for five years. I don't understand how or why that works but she swears it worked.

Good luck with your efforts....if nothing else take a trip to the nursing homes and visit the COPDers. That might provide some good motivation. It keeps me from even trying it.