VentMedic

Those things need lights and sirens to warn anyone or anything in their path.

http://abclocal.go.com/wabc/story?section=news/local&id=7171794 The patient was 100 y/o with abdominal pain. It is unclear or it hasn't been released yet if L&S were being used. The pedistrian was at least in a crosswalk even if she forgot (or maybe not) hit the button for a walk signal. Regardless of "Walk" signals in areas like Florida we have to still be cautious of crosswalks as it may take some elderly people several lights to make it across the street. Spenac might be able to elaborate on how long it takes him so that we might have a better insight on this tragic event. Regardless of who is at fault, something that causes serious injury or the death of a person affects everyone involved and their families.

I wonder how many would actually consider being an EMT if the ambulances had no lights and sirens? Look at the stigma the transport companies which are just "routine" trucks have. Yet, some wonder why these companies are not more prevalent. Besides all the start up and maintenance costs, could it be that there is a shortage of qualified people who want these jobs? They would much rather drive real fast with L&S than to provide a safe transport for patients to and from appointments and procedures. Thus, there is no shortage of EMT applications at ambulance companies or mills that mass produce EMTs. Some are even to drive an ambulance for free if they can play with the lights and sirens occasionally. We have actually had some comment to the Specialty Team members when we must use an ambulance service to and from the helicopter in another area that the "baby or kid" can't be that sick if you don't need light and sirens. What they don't consider is that if you know what you are doing and have confidence in your abilities why would one ever run lights and sirens with a patient on board except for a few dire situations or in a few traffic conditions? If the hospitals have confidence in your assessment abilities, they can prepare for whatever you are bringing to them to where very little treatment time is lost. Unfortunately some companies that are ALS still have a "BLS" mentality and the hospitals will also perceive them as such regardless of the patch.

This was a dedicated neo team that had no reason to run L&S. The RN and RRT knew the parents were going to follow and told the parents that it would be a gentle ride to the Children's hospital. The trip started out that way but the EMT hit the L&S to go through a red light before the team could stop him. Of course that freaked out the parents who didn't know what to think when the truck lit up and darted. The EMT's excuse "he wasn't running code 3 but just didn't want to wait at the light". This is essentially what you stated in the following paragraph. This was a sad lesson to be learned by all specialty teams which eventually got their own trucks and their own drivers. It sounds like that was not a dedicated Peds transport team but rather something like "who wants to ride in the ambulance situation?" This is truly the most dangerous situation since they are not a "team". Our teams are RN/RRT or RN/RN with a doctor used only for ECMO transports. If you are on the team you go. Our attorneys have also told us about the liability of running L&S to and from the airport or even to a local hospital. If we spend 4 hours in the hospital stabilizing a child, 2 more minutes will not make a difference.

Wow! That jolted a memory. Many years ago before the Children's hospital got their own transport vehicles and drivers (non-EMT), they used the local privates and it was often the luck of the draw for what crew you got. The Neo/Pedi teams only need a truck so they hired BLS for each transport since the team supplied all the equipment and were a rolling NICU/PICU. Unfortunately, some EMTs did not realize they didn't need L&S or speed and the teams preferred just a nice ride back to the Children's hospital with the child especially after they spent 2 -4 hours stabilizing the child at the other hospital which may even have been somewhere in the islands for a 12 hour transport. 2 more minutes were not going to matter. Anyway, the team had just picked up a 3 day old infant at a hospital just across town and the parents were going to follow in their POV. The EMT driver was freaked over having a very sick child in his truck and started driving L&S and rolling through the red lights even against the protests of the neo team. What they didn't realize was at the first light he rolled through, the parents also rolled through only to be struck broadside by one large truck and then another vehicle hit them. They were dead at scene. The baby recovered but to not have parents. Now, we prefer to have a driver (non-EMT) from the transport pool and one who does not need to know anything about the patient except what we tell them and to give us a professional limo ride with no L&S or speed to and from our destinations. The same goes for our pilots. We never yell out something stupid like "they're coding" because their focus should only be on the aircraft and not what is happening in the back unless there are other options. Part of being a Paramedic or on a Specialty team is that you know what your own capabilities are and are able to provide care to the fullest for your job title. Usually we are the higher level of care for miles around.

Just had this discussion again on another forum. Forget the freaking EMT thing. If you are working as an educator or teacher in a school system, as educated individuals responsible for children several hours a day 5 days a week, you have a greater responsibility than someone with a 110 hour first aid certificate. You do what your job description calls for as an educator or teacher. Leave the stupid very limiting EMT cert at home if it is not mentioned anywhere in your job description as a teacher in the school system. Teachers have no less than a 4 year degree with most likely a Masters or Ph.D. They are mature individuals who understand the responsibility trusted to them and they understand children as well as having some idea of what the disease is they are treating which is more than one can say for either the U.S. EMT or Paramedic since pediatrics is lacking in the curriculm. Imagine if all the certified Paramedics working as McDonalds while waiting for their shot at the FD thought they were hired for their ALS skills and not the ability to flip burgers. They have to do the job they were hired for.

Save yourself some grief next time and use the "search" function. Just about every EMS forum has had a couple discussions about his school. Also, few are going to listen to advice when a school offers such convenient classes and easy financing (that one will pay dearly for many years. Let's not forget the cool commercials and the great sales pitch that promises a rewarding career full of excitement. And, you don't have to take all that education stuff where in some colleges one might even have to take A&P. Schools like this are an easy way for someone who lacks motivation or has no interest in medicine to get a medic cert. They get their hours and are taught how to pass a test all for $12k and 6 months of training. Of course you can get a package deal for just under $20k if you take the EMT class with them.

The state has tried but this chain (6) of medic mills has the support of the FFs' association and union. However, it seems he was not sponsored by a FD or he wouldn't be complaining about their "practices". Thus, if he complains too loudly, he ruins his chances of getting on with a department.

The medical history of the dummy in the testing lab is not known and it is possble there were some other underlying causes to a poor resuscitation effort by this Paramedic. Yes, you may be right that could be a good defense. As far as the 39 y/o thing, this week alone I have seen 4 people under the age of 40 in the CCU with significant MIs and this has been a slow week. Look at the ages of FFs that have had MIs and several fatal ones in the stats. Lifestyle, diet, stress and genetics are all factors.

What?! I can't believe it! Say it isn't so!

She would have to work a few years as an RN to get those positions. Of course, she might be able to find an ambulance service that just hires whoever regardless of experience which there are a few in CA known to do that. For the cost of an EMT class at NCTI she could get a whole Paramedic degree at a California Community college with the very low tuition rates in that state.

I hope the critics of Dr. Tober in Collier County, FL are paying attention to this.

EMS still has not reached out for preventitive medicine although some aspects of prevention are emphasized if you are involved in Public Safety. When I had surgery a few years ago, I did ask about the qualifications of the anesthesiologist. Even though I have nothing against CRNAs, it was my preference not to have one doing the procedure. My vocal cords deserve someone who can intubate and if that is part of your job description, you should be skilled and well educated about doing it just as you should know when not to do it. If a surgeon has one's best interests, he/she should be good at surgery. Just best interest of the patient is not always enough in an emergent situation if one can not perform the task at hand. A patient may not always plan ahead with a list of questions to ask you at scene but they disserve to have someone who is proficient in a few skills and have the knowledge to use them to the best interests of the patient. If you can not get the time in on actual patients either in or out of the hospital, your company should provide at the very least an intubation dummy head for practice. With that you can also practice organization and communication with your partner so there is no fumbling of equipment when the time finally comes.

Florida still uses its own Paramedic test because it contains questions that are specific to the state. The passing score on Florida's exam is 80% which is higher than the NR's equivalent by however the NR is scoring its test now or so is the argument.

Bad advice since the new education levels have been announced and the NREMT exams are changing. http://www.ems.gov http://nremt.org/nremt/downloads/Newsletter_2009.pdf The CNA gets more hands on experience and the opportunity to work in different areas. They also would be the better choice for IFT transports rather than the EMT since these patients rarely need first aid but someone who can do vitals and have experience with medical needs patients. Nursing haa been eliminating the LPN from acute care situations for over 20 years and have restricted, not enhanced with a few skills, their roles in patient care. These "inbetween" providers just can not meet the demands of health care. The only thing missing is the education. 600 hours of training from an unaccredited medic mill does not equal an accredited degree which is entry level for the RN. A profession that still has people (FFs) who are forced to become what they shoouldn't can not be compared with nursing.

Hypothermia has been around for a few decades but the technology hasn't been adequate either in or out of the hospital to achieve the results needed to prove itself. The exception was in neo and pediatrics. There are now enough advances in the cooling methods to obtain the desired results but for the U.S. the problem still lies with lack of adequate sedation and paralytic protocols if needed by some of the medics. And of course some are still relying on ice packs which lacks consistency and efficiency. In the 80s when we did the prehospital studies on near drowning patients (peds0, we iced the head and neck region...with ice which was a challenge in Florida. We were trying to simulate a Minnesota lake which is essentially what we got in the back of the truck. However, the effectiveness of bystander CPR for a witnessed arrest with early activation of the 911 system is still the biggest factor in how well the patient does.

You have NY listed as your location. In the U.S. it is a little easier to do both where the Paramedic only requires a few hundred hours of training and the RN is still just an Associates degree for entry level.

Sad. So very sad. If you are going to carry, you must stay in control of your gun at all times or store it safely.

You're not confused? Fire science deals with fire stuff. RN and RT, both different degrees, deal with medical stuff. You have stated over and over on the forums that a tech cert is good enough for EMS. You have balanced you retirement fund numerous times on the forums. If you don't have a clue about what you want to be none of us can help you out. If your worried constantly about the financial side, just be a FF. If your FD allows you to drop your Paramedic cert, even better. Believe it or not there are many of us in EMS who own homes and have a nice retirement set up. We also managed to get our education without all of this drama. The reason most of us were successful is we know we wanted to do patient care and be good at it. Success and prosperity comes in many ways when you do what makes you happy. It sounds like even the FD wasn't your choice career either but you did it for the money. That in itself is scary for the public you serve and the FFs who might have to depend on you if you are not preoccupied texting your accountant.

This post only makes you appear very unorganized and clueless about any of the other career choices or what they are about. The RN and RRT are very different degrees and not everyone is cut out to be either. RT is a specialty. The RN has a culture all to its own and people who enter now just because of the money are being washed out quickly if they have no interest in patient care. Since you are constantly bringing up your checkbook rather than any aspect of patient care, you fit into that category. You truly don't know what you want and can't seem to justify your motives for any direction be it firefighting as a public service and leadership promotion or being a Paramedic with patient care in mind. You have discussed this to a nauseating level on all the forums. Education is an investment that can last a lifetime. Your bank account may not last to the end of the year given the right circumstances be it illness or a good scam draining it. You have totally selfish reasons for getting ONLY a tech cert and you seem to keep forgetting there are patients involved that deserve someone who can calculate their medications and not someone who is not distracted by constantly balancing their retirement fund. Even with the Paramedic cert which will give you credits at a community college that offers an EMS degree, you make an extra 20 - 30 credits sound like a doctorate program that will waste years of your time. Don't go back to college. Do patient care, EMS, RT and Nursing a favor; stay on an engine and stop whining. You've already done enough damage to FF/Paramedics who do take their jobs serious enough to continue their education and are in it for the patient care. This also goes for the FF who continue to a Fire degree. Others working for the FD have found ways to continue their education. Those who haven't advanced their education at least can come up with a better excuse than you. If you can not see the importance of education as it pertains to the future of EMS or how it benefits the patients, just stay on an engine and continue to obsess over your money.

Strange how this is evolving... It is hard to tell if they are decreasing or compromising care for the sake of involving the FD. Not a good article for fire based EMS. Posted: Wednesday, December 2, 2009 http://www.emsresponder.com/article/article.jsp?id=11290&siteSection=1 Council to Vote on Creating Lima FD Ambulance Transport Service

My exact words were about 5 years. Okay so there are 2 services that got started between 5 - 10 years and a few that just recently got their 12-lead capability. But, from what has been stated from Michigan's EMS officials, the state is largely volunteer which is why they are arguing against the CoAEMSP standards. From the 2008 survey is looks like almost 50% are volunteer and many of those are probably just BLS judging by the number of EMTs/FR vs Paramedics in the state. Thus, again when you throw a number like >90% can activate, that may mean little if only half of the state even has ALS and not all of the ALS providers have 12-lead capability.

HVA bought their 12-leads in 2001 and went live officially around 2002. Just how old are you since you also worked for 11 years in Europe?

I didn't ask any questions that require an answer. What service were you with? When the data was being collected for prehospital 12-lead usage, Michigan was stil looking to establishing theirs and only a could of agencies were considering it in the late 90s. A few years later a few more did consider the 12-lead and did impliment the programs. Thus 12-leads in Michigan seem to have come about later in the last 10 years rather than earlier. Detroit FD was attempting to get their program started around 2005 as they were still working on the technology side with the hospitals. That acutally was an interesting conversation on another forum and at one of the EMS conference to see them evolve while still plagued with other controversies.

With so many decent colleges in VA with reasonable tuition, especially at the community college level, why would you want to go with a questionable mail order program? If you are going to do online, just about every college offers that method of teaching for some classes. Using one locally can give you greater access to their resources including the labs. You can probably transfer your Paramedic cert much easier within state to a good A.A.S program. That may leave you only about 24 credits to finish that degree. I still don't see how you 46young, who have preached money matters, could get suckered into such quick fix degrees to suck your money out of your bank accounts with numerous extra fees and out of state tuition as well as classes that may not even pertain to your own state's requirements. Instead of look for some elaborate scheme, just go to your local community college. It is only a cert to Associates degree. They can also do personal counseling for the correct classes for your goals and get you financial aid advice if you need it. At this point I don't think you have a clue what you want to do so it is best you get advice that can be applied broadly. Also, if you choose an out of state program, those classes may have difficulty coming into your state especially if they are from a private school. And remember, some science and math classes have a time limit for transfer which is 5 or 7 years depending on the state. Also, if you want to obtain another health degree in the future, you need to take real college level A&P and pharmacology. Trying to CLEP out of these classes based on the overview sections of these courses offered in a Paramedic cert program is not a good idea. Picking up a book entitled CLEPPING Pharmacology for Dummies is also not a good idea as the title will give you some clue as to why. If you do not have a thorough understanding of these subjects, while you might pass the course, you may just skim by which does the patients who will be in your care a disservice. Inhospital and critical care (including CCT) pharmacology requires an indepth understanding and not just a gloss over. Med-surg pharmacology alone can be very expansive with numerous meds and the provider must understand the meds well enough to teach as well as just do the skill of setting the med at bedside after matching the names of the medications from the orders.