Chrisclark

Then at least you gave it your best shot. It is better than sitting there going "HMMMM I wonder why this pt looks like a smurf? I love smurfs! That papa smurf was kind of weird! I wonder if he ever.... Even the lowly first responder must begin the diagnosis prosses. He sees the blue pt and belives it is an obstructed airway. If he is right, the pt may lives. If he is wrong, he can still do his best to ventilate the pt. A diagnosis of hypoglycemia is something a first responder may see. Glucose could save this pt's life but if the first responder does not have the balls to think hypoglycemia when they see the medical alert bracelet then the pt may very well die.

Everyone in EMS from the Paramedic to the first responder has to diagnose from what they know about the pt. I will never diagnose a mitochondrial disorder in the field, but damn it, to be able to use a 12-lead EKG (ECG whatever floats your boat) to see the pericarditis (something I can't do as a basic) is what saves the pt's life rather than just prolonging it with CPR after they go into a deadly arrhythmia. Diagnosis saves lives, whether it is legal or not.

One point nobody has made on Public CPR courses: For a layperson CPR is a skill that must be practiced and used regularly, otherwise people forget how to do it, or get lazy on how to do it. Laypeople having CPR classes would probably do more harm than good. Laypeople already drag pts out of cars before EMS arrives. Thinks about what would happen if they improperly checked a pulse and began chest compressions. Their hands are too low and they break off the xiphoid process and lacerate the pt's liver. Even wore than that, they can compress at a funny angle and snap ribs in such a way that whey cause more internal injuries. In all reality the pt still has a pulse. Laypeople doing CPR once every 2 years is not enough practice to do quality BLS. As for medical shows, I like watching House. I have not seen many errors on it. (there have been some though, Last week house exhibits wide complex SVT which immediately ceased into Asystole. If I remember correctly they "shocked" his heart out of asystole too.) Another one, Scrubs, I crack up every time they intubate someone because it is so casual like they are not even looking at the pt. Crazy doctor shows, you would think they would hire someone to make it more authentic.

MY mother's boyfreind is a basic instructor in another program. I get to hear all kinds of stories when I go home on the weekends about what his sorry bunch of basic students did now. For example, as an experiment he gave them all of the reading material needed to find out how to properly extricate someone using a KED. They knew how to use a short backboard already. Hardly anybody in the class could figure out to use the dang thing. The material was sufficient. The students just would not read it. They ended up sitting around and talking. Most of them did not even attempt to apply the KED. He says that he thinks maybe one or two people in his class will pass their registry test. There are some really sorry basics on their way out of school right now.

I know I am new here so I will try to keep it short and to the point. I am not even certified yet and have not finished school. I just graduated high school in 2006 and have worked as a lifeguard. EMS just felt like a natural thing to do for me because it interested me and I have many family members in medicine. Just form work as a lifeguard I have worked with some truly amazing Basics and I have worked more distantly with some awsome medics. I have also know some incompetent Basics, and some medics that were sad excuses for individuals. The bad, however, always seem to stand out in your mind. The worthless basic is remembered and the cocky medic is also remembered. The medic that taught you how to get an I.V. started perfectly every time is not quite as memorable. It even applys to the first responders. Some of the guards I worked with were worthless I remember these more than the ones I would trust my own family to. My skills as a basic student are (hate to toot my own horn) are top notch because I obsessively study and practice. I also read all kinds of books just so I can be ahead of the curve. I realize that even as a basic, if I kill somebody, that will haunt me for the rest of my life, especially if the medic takes the heat. The person with the most training is responsible for whatever rig you are running. In ALS rigs, that medic is the go man. He is the captian of that ship. That really sucks for the basic, but tough. If you want to be in charge go to medic school. The other side of the coin is that the medic cannot be overbearing. If the medic is a pain in the ass the pt suffers.