VentMedic

Like Texas, Florida offers the Driver's License test in Spanish so some can start out as Drivers for some ambulance companies and do some OJT for skills while taking a class that is Bilingual to get them enough EMT knowledge in English to pass the test. Most students are from countries where their educational systems are at a higher level than that in the U.S. and many already know at least two or three languages. It is not that difficult for someone who comes from this type of educational background with higher expectations to pick up enough English quickly with an EMT text book that is written at about the 8th or 9th grade level to pass an EMT exam. You may also have to consider that some were in some type of medical profession in their own country and the EMT-B is probably just a review of the "basics" they already know. Thus, with their abilities with at least 2 - 3 other languages and soon, English, those from other countries are an asset to companies in large tourist areas. Many of the foreign students have a reading comprehension that is considered well into college level by U.S. standards when they graduate from their high schoools which is above what many U.S. kids are graduating at. Their math and science programs are also much stronger in material than that of the U.S. Thus, students from other countries do have an advantage as many are able to enter into our college systems without a great proficiency in English and do very well. Most will master the English language while completing their studies in our colleges. However, for those that work as EMTs in certain parts of this country may not need to know much English to still function very well. If you look around at some of the EMS forums or run reports, a few of our own American born kids can not write English proficiently or even communicate verbally very well in it. Overall, the U.S. kids are disadvantaged when it comes to education.

I have lived and worked most of my life/career in foreign countries, Miami and California, and there are times when English is the foreign language. The biggest problem I had, even with my own abilities with the Spanish language, was communiticating mechanical failure with the truck to the all Spanish speaking mechanics when I couldn't get the translation to come out correctly. Too many dialects of the Spanish language to sort out. Eventually I would just say "No va" and let them figure it out. The EMT-B exam is not that difficult to pass since it seems the U.S. schools already specialize in "teaching the exam" rather than providing the education. The hands on is mostly "see it" and "do it". It also wasn't that big of an issue when I had a non-English speaking driver or EMT partner since their job consisted primarily of skills. I actually found my partners from other countries were quick to catch on and had good patient care qualities even without speaking the same language as the patient or their partner. In the hospitals, it is sometimes difficult as we have many professionals speaking different languages. Fortunately, if you can not understand the orders a doctor is giving due to their strong accent, they can just use the computer to give us a printed version. I do find it annoying when bilingual people speak in the language other than the patient while in their room. After reading what I just typed, I am probably not the best to comment because I don't know what language I should be referring to. For some reason I think English is not the language of the countries I live/work in now that I think about it.

It truly sucks to be a patient advocate in EMS. You can always expect to be bashed if you offer the views from the patient, hospital or HHA's side on some situations. Tell us about your experience with disabled patients and home care situations. Have you done anything to improve the situation? Have you talked to quads, paras and the elderly about their frustrations? Have you talked with the reps from LifeLine or whatever company in your area? Have you offered training to the home health agencies? It may sound like I'm over the top because I provide additional information and not just find someone or something to blame. Seeing the situation in only one dimension does not give you a full view of the problems. Blaming the patient is the easy way out. Of course, some in EMS would rather just piss and moan on an EMS forum about their dislikes about the system and patients rather than attempting to assist companies to find a better solution for their clients and patients. Thus, you become as much of the problem as those that "abuse" the system. As least HERBIE is consistent. However, he doesn't consider the budget cuts that have put patients into home care situations with inadequate resources. I seriously doubt if he has participated in any petitions to get more funding for Medicare. EMS is a "me first" profession which is also why it doesn't get much support from other healthcare professions in some of their efforts for better funding. Other professions (NP, PA, RT, OT, SLP, RN, PT, MD) include the patients when they are lobbying for better reimbursement and funding. They don't criticize medical needs patients or the agencies that attempt to provide the with care. They try to work with these companies to see how the patient can be benefited and in turn, it usually benefits them as well. But for some opinions here, it would probably be easier just to build large nursing homes warehouse style instead of trying to work out some home care situations. Now, for those who want to say "I'm over the top" again, please for to the national association websites for any of the professions I mentioned and see what legislative actions they are working on. I don't just pull this stuff out of thin air. It comes from many years of being active in both of my chosen professions. Unfortunately, EMS has been the toughest for legislative issues largely because of the "me first and only" attitudes that exist in this profession. This is true for some individuals and the many different agencies that do EMS. It is also evident by the 50+ different certs this profession has just to please some and not for the benefit of either the profession or the patient. The new big screen TVs, patio furniture and barbecue sets are a pretty nice also. I also find that those who run only 2 calls per 24 hour shift complaining the loudest about being overworked with LifeLine calls. Those in busy areas are usually relieved when it is a public assist patient where the lifting and paperwork are minimal.

The system is not perfect and the OP did not state what other resources the quadriplegic person had. I would hope that he had a voice activated phone but for some that might not be the case. Also, some systems do call the person before sending a fire truck and an ambulance. If it is not emergent, the primary care giver might be called. The systems are not always perfect but by no means is it always the patient's fault. Find out how the system can be improved and don't just lay the total blame of inappropriate use of EMS on the quadriplegic person.

"Trauma" has now invaded my home away from home and just finished filming an upcoming episode on the little island city of Alameda. They also sent out invitations to the local FDs and ambulance services to star as extras in their own costume. The episode will air Nov. 23 and is titled "Thank You" for those of you who are keeping track. The filming was done at the closed Alameda Point Navy Base and will be the scene of a huge plane crash with hundreds of victims. Lots of fire, smoke, screaming and the actors running through the fire and jet fuel with no protection what so ever.

We actually don't have a shortage of nurses that can give vaccinations. Many hosptials and clinics are using the ones assigned to light duty. However, to reach more people in various areas, some Fire Stations are being considered as places to get vaccinated. Florida already has a Public Health statute in place from many years ago that allows Paramedics to be appropriately trained to do the task. Some states don't have specific statutes for EMS but they may have recently added a Public Health law. Here are a few updates on the CDC website. http://www2a.cdc.gov/phlp/H1N1flu.asp For specific info look at the section Mass Vaccination - Legal Authority to Vaccinate

I wish you could attend some of the training sessions we have with our quad patients so you could hear about their "stresses" as well. Unfortunately for them they don't have the option of leaving the business but rather just want to leave life. Some patients do learn the hard way that they must be thankful and express it often for whatever help and attention they get. The mad and unhappy ones will not get that drink of water when they want if if they are thirsty or will get decubitus ulcers. They also will not get their glasses placed on their face to watch TV or their eyes rubbed when they itch or get something in one. When working in the rehab center I may get as many as 10 STAT calls a shift for everything from misplaced glasses to a dislodged trach and a very apneic patient. I take each one as that patient's own emergency with a little coping education from myself and the other highly trained/educated professionals I work with. Hopefully each "emergency" will better prepare the patient for life on the outside. But, many find out all about the struggle starting from the transport home with a couple of poorly trained/educated EMTs. Thus, we teach our patients to become educators to teach the less educated/trained for their own survival.

Yes I know this is in the funny section but I have spent many hours getting patients with severe disabilities home and have tried to work with various agencies and professionals to make the transition go as smoothe as possible. It is not always a matter of "coping" but rather results of a traumatic brain injury that can bring about a personality change. Many family members are often shocked or ashamed of their loved one's different behavior when they do start responding after a traumatic injury. Some abandon their loved ones to where some of the rehabilitation is affected without their support. Let's look at this from the perspective of a rehab facility. Having our patients laughed at is one of the fears we do have when we are preparing our patients for as much independence as possible. Unfortunately services like Lifeline are not perfect and instead of notifying their appointed primary care giver, they call 911 only to put our clients through a situation like this. While the patient may seem to take this in stride, the remarks made on scene do affect them and they try to make light of it in spite of their embarrassment. When they gather for more training or group support, I am often saddened to hear how some have been treated especially when they are not always in control of who their Life Alert or LifeLine system notifies. Instead of taking it as a big joke, especially with the new EMS provider, maybe some education and some notes on how the notification system could be improved might be in order. We are always looking for suggestions to work with the various agencies such as Life Line (or whatever in the area) and EMS to make our patients' transition back into some type of independent living successful. Nothing like a bunch of snickering FFs to undo months of work toward building the confidence of someone who must live with a broken body. Do whatever you can to improve the system instead of just complaining or laughing about it at the patient's expense of possibly losing what freedom they do have because of a poor system function. We still have a lot of patients and are getting more each day that would like to have a chance at independence even when severely disabled.

This is California and unfortunately the area in not in the OP's favor for that. To find a Paramedic, 911 EMS is largely Fire Based. CCT utilizes RNs with EMTs as drivers and helpers. The very few ALS IFT trucks around are extremely limited in protocol that there is not much demand for them. Often a hospital will just book a CCT with a nurse rather then going through the long list of what a California Paramedic can not do. It is also a safer bet if the patient requires another med or technology during the wait time for the ambulance. When that happens and an ALS Paramedic truck arrives, another delay in transfer will happen while a CCT with a nurse is dispatched.

Looks like you are hitting all the EMS forums today with your message. I guess I'll repeat myself on this forum. In all fairness why don't you post a comparison of other transport services in your area to see if benefits, wages and bonuses are similar? Even in the SF Bay area, it is difficult for an EMT to demand much for wages. Realistically, 3 months of training and "BLS" care for 4 or 5 patients per day doesn't bring in the big money. With the short time for training and the many tech schools mass producing EMTs every 3 months or less, there is an abundance of EMT-Bs in the area just waiting for a job that at least offers a paycheck and/or health insurance. Many laid off and well educated people from Silicon Valley are now working as EMTs after a quick course just to keep their families insured and bring in some money. Some are just trying something different while inbetween employment contracts. Of course they will probably return to their other careers and lifestyle once the economy in that area picks up. If you don't like your job you can try to go elsewhere but as an EMT-B you might be limited.

This should prove to be an interesting and controversial flu season. It should also present arguments for other medications and devices that haven't been approved by the FDA. Emergency Use Authorization of Peramivir IV http://www.cdc.gov/h1n1flu/eua/peramivir.htm The Canadians are watching this also: http://chealth.canoe.ca/channel_health_news_details.asp?channel_id=131&relation_id=1883&news_channel_id=131&news_id=29303 http://ca.news.yahoo.com/s/capress/091023/national/flu_new_drug Newspaper story: CDC Makes Unapproved H1N1 Drug Available The unapproved antiviral that saved a teen's life is now more widely available in emergencies. http://www.emsresponder.com/features/article.jsp?id=10893&siteSection=24 Oct. 29--He was a healthy teenager from another country, visiting friends and relatives in Minnesota, when he got sick. Then really sick. In early September, he wound up at Hennepin County Medical Center in Minneapolis, near death with complications from H1N1 flu. But his doctors there were able to get their hands on an experimental antiviral drug that saved his life. A month after he was admitted, the teenager walked out of the hospital and was able to go home to his own country. The 17-year-old boy, who has not been identified, was among the first H1N1 patients in the United States to get the new drug, Peramivir. On Friday, the U.S.Centers for Disease Control and Prevention (CDC) took the unusual step of making the unapproved drug available to hospitals across the country for emergency use in just such cases. Peramivir is similar to other antivirals, such as Tamiflu. What makes it unique is that it can be given intravenously. Other, similar drugs have to be swallowed or inhaled with an inhaler, and are widely used both in and out of hospitals. When patients are near death or in organ failure like the 17-year-old at HCMC, an intravenous drug is the only option, said the boy's doctor, Dr. Stacine Maroushek, a pediatric infectious-disease specialist at the medical center. "I don't think he could have been any closer to death without dying," Maroushek said. He had severe bleeding in his digestive track, almost every organ had failed, and he was on a ventilator to help him breathe. Doctors could not have gotten any other antiviral into his system, she said. But Maroushek was familiar with an experimental drug made by a small company called BioCryst of Birmingham, Ala. She had to get permission from the U.S. Food and Drug Administration to use the drug in the boy's case. That meant she had to fill out numerous forms, get permission, then contact the company, which sent it to her. "We were able to get it within 24 hours," she said. "After he was on the medicine for a day and a half or two days, he started turning around." Like all antivirals, the drug works by suppressing the growth of the virus in the body, allowing the immune system to fight off the infection. Since early September, the drug has been available on what's known as a "compassionate use" basis around the country for hospitalized patients with severe H1N1 infections. Maroushek said the teenager at HCMC was the third person and the first pediatric patient in the country to receive it. That doesn't mean, however, that it will always work. The same drug reportedly was given without success to Michael Milbrath, the Waseca hospital executive who died Saturday of complications from H1N1. On Friday, his family said on his CaringBridge website that Milbrath, 54, had received "the new experimental drug" at Immanuel St. Joseph's hospital in Mankato. Milbrath had been hospitalized Oct. 14 in intensive care with complications of the flu, according to the CaringBridge site. As his condition worsened, doctors received permission on Oct. 22 to use Peramivir, and the drug was flown in from the East Coast overnight, the family reported. He received the drug Friday, but died the following day. His funeral will be held today in Waseca. A spokesman for the medical center declined to comment on Milbrath's treatment, citing patient confidentiality laws. Under the new emergency-use designation, doctors can get Peramivir directly from the CDC in Atlanta, Maroushek said. It is designated for patients who have run out of other options, either because other treatments failed or they can't use other antiviral medications. Doctors must report any side effects or complications to the federal government. The company, BioCryst, said last week that it has donated 1,200 courses of the drug to the federal government for use during the flu pandemic. It also said it is producing 130,000 more and is prepared to make additional doses, if necessary. The company is conducting a formal clinical trial in 400 patients nationwide that is expected to be completed by April 2011.

I have spoken with a couple of flight team members from REACH and they have not been amused by this show at all. They do bring patients to SF from outlying areas by landing outside the city. Unfortunately for them their jumpsuits are very similar to the one on the show. But then, they also stated not many health care professionals in the hospitals have watched the show and most of the ignorant comments come from the EMT(P)s in the amubulances that transport them to and from where they must land. This show should have been promoted as a comedy or spoof of EMS rather than a drama of the producers' version of reality.

You have not seen my patients in Northern California. These are the original flower children from the Summer of Love. Some are now in nursing homes sitting in their tie-dyed Tees while listening to the Grateful Dead. Others still run flower stands. I see some 60+ y/os in business suits Monday-Friday and then smoking marijuana while wearing their tie-dyed shirts in some park on the weekends. This is no joke. Parts of SF, Mendicino, Humboldt and Butte Counties are like a trip back in time only with gray hair. But, I do like the Grateful Dead so it's all good. Of course, some of my patients do smoke marijuana for medicinal purposes and for those, whatever they wear is okay. Also, if you watch a video of this CA assembly meeting, it is easy to see what generation some of the players are from and what areas. I imagine the tie-dyed tees will come out later after the suits come off.

Considering the mess that the Mayor of SF and the State of CA have made out of the gay marriage issue and after putting some gay couples through a type of legal marriage ceremony only to try to yank it out from under them later, I would hope it will be done with some sensitivity. However, I don't think anyone in SF is watching this show any longer. The only ones watching are those who want something to talk about on the EMS forums. I'm not watching the damn show and I'm even typing about it.

California held its 1st Hearing On Pot Legalization today October 28, 2009. http://cbs5.com/local/california.marijuana.legalization.2.1277118.html SACRAMENTO (CBS 5 / AP) ― No tie-dye was on display at a standing-room only hearing held by a California lawmaker on Wednesday in a bid to get his marijuana legalization bill taken seriously. Instead, suits and sober discussion were the rule at the state Capitol as Assemblyman Tom Ammiano presided over what his office said was the first legislative consideration of the issue since California banned the drug in 1913. Though both sides of the debate were heard at the hearing, Ammiano has long had his mind made up. At a news conference before the hearing, the San Francisco Democrat and former comedian called the criminalization of marijuana a failed policy that denies the state significant revenue. And despite opposition from Gov. Arnold Schwarzenegger, Ammiano said he believed the bill put the state in a position to set the national agenda. "I think we have a real shot at it, particularly in the context of it being in some ways bigger than California," Ammiano said. His bill would tax and regulate marijuana in the state much like alcohol. Adults 21 and older could legally possess, grow and sell marijuana. The state would charge a $50-per-ounce fee and a 9 percent tax on retail sales. While at least one poll showed a slight majority of Californians would support a tax-and-regulate scheme for pot, the bill's chances remain hazy. Skeptics have questioned whether the state could truly enforce a tax on marijuana, especially since the paper trail could lead federal prosecutors straight to sellers' doors. Speakers at the hearing touched on most issues common to the marijuana debate, including whether legalization would increase or decrease crime, raise or cost the state money and help or hurt children. No vote was taken at the hearing, described as "informational." The proposal has been referred to the public safety and health committees, which will consider in January whether to send the bill to the full Assembly.

SF is not that big to where they need HEMS. However a helipad would be nice at a couple of the hospitals. SFGH, the trauma center, has been trying to get a helipad approved for many years. The arguments used against it are now featured on the TV screen. The medical helicopters in the surrounding areas are generally staffed by RNs since CA's protocols for Paramedics are very limiting.

No medical helicopters in SF. No helipads at any of the SF hospitals. I would say they landed on a set somewhere outside of the city but since I don't watch the show, I can't say. I was inconvenienced enough by their filming downtown when I was there. BTW, makeup is a marvelous thing for some of these actors.

I now find it rather disturbing that now the states and hospitals that wanted to mandate the vaccines are now back pedaling with both the Season Flu and the H1N1 vaccine. The hospital I am currently affiliated with issued a memo for "highly recommending" the Seasonal Flu vaccine with an ongoing discussion for mandating the H1N1. A couple of other hospitals in the area had already made the announcement for mandatory vaccine and provided strong arguments for this mandate. Now, my hospital had trouble getting enough Seasonal Flu vaccine so the only direct care staff members that are getting the vaccine are the RNs, RTs and Doctors. They totally left out the CNAs who may have even more exposure time than some of the others. The talk now is that the hospital is going to very selective out of their selected licensed staff group for the H1N1 vaccine. For the H1N1 vaccine, only 22 million doses have been distributed of what was supposed to be at least 40 million at this time. Many of those doses are going to private physicians while some of the clinics and hospital systems are trying to prioritize the priority list. It makes me wonder if those who actually should be vaccinated will possibly be overlooked. New York State rescinded their statewide mandate for health care workers. The hospitals in my area have now shut up about their "mandatory vaccine for all employees" talk as people are asking questions as to "why is its importance not be stressed as much now that they don't have it?" Does it make the H1N1 less dangerous now that the hospitals can not issue their mandate? For the hospitals that had initially mandated it for all employees but now will only give it to a few, does this send a message to the importance of front line workers like CNAs vs the RNs and RRTs? What about the people that have insurance and can go to a private physician vs someone who now has to be prioritized for the vaccine off of an existing priority list at a county clinic? I still believe H1N1 is very serious and I have seen first hand what can happen to the young and/or pregnant. However, I just find it rather interesting that since the government could not fulfill the vaccine orders and the hospitals or states could not carry out their "mandates" but now must prioritize the HCWs and citizens, the talk is now toned down.

Definitely not bashing it as a few of the hospitals I have been at support it for medical uses and do believe it is better than Marinol. It definitely is a better perspective on marijuana than reading the numerous threads on an EMT forum about "I smoke pot. Can I be an EMT?"

Colorado newspaper hiring marijuana critic 10/20/2009 http://www.insidebayarea.com/search/ci_13601956?IADID=Search-www.insidebayarea.com-www.insidebayarea.com DENVER—The store has a television lounge and a pool table, and snacks and acupuncture are free for customers who drop up to $130 an ounce on 16 varieties of marijuana. But a reviewer of the business warns the decor looks a little cliche, what with the Grateful Dead posters on the wall and the Mexican-blanket tablecloths. The medical marijuana review business is booming as states like Colorado and California have seen an explosion in the number of pot shops. A Denver alternative newspaper recently posted an ad for what some consider the sweetest job in journalism—a reviewer of the state's marijuana dispensaries and their products. Medical marijuana users can also look to dozens of review Web sites, even mainstream rating sites such as Yelp or Citysearch, to find their high. At least five iPhone applications allow weed fans to find the closest place to legally buy bud in the 14 states that allow some sort of medical marijuana. The Denver paper, Westword, has already has gotten more than 120 applicants, many of them offering to do the reviews for free. When the newspaper settles on a permanent critic for its new "Mile Highs and Lows" column, industry watchers say, it will be the first professional newspaper critic of medical marijuana in the country. There's one condition: The critic has to have a medical ailment that allows them to legally enter a dispensary, and buy and use marijuana. Read more at: http://www.insidebayarea.com/search/ci_13601956?IADID=Search-www.insidebayarea.com-www.insidebayarea.com

If it takes someone 2 - 3 years of street experience as an EMT-B to learn how to change a regulator on an O2 tank or lift a stretcher, this is probably not the profession for that person. What you have described is either and/or a school failure or someone who just doesn't get it. It is not an indication that every well educated Paramedic will be inept at simple skills. If a Paramedic program is properly done, there should be close to or over 1000 hours of clinicals as there is for other professions. The "basics" of the equipment that a particular company uses should also be covered in orientation. The O2 regulator thing can be tricky as there are about 20 different types depending on manufacturer/application and one should be made familiar with the one that company uses. The "basics" should be learned in the first month of Paramedic school and then one should move on to the nitty gritty medical education. It is of no use for one to just go through the motions of taking a BP and doing basic first aid if you have no clue about what you are assessing or what you should be assessing. In fact, EMT-B does not teach what one needs to know about 95% of the IFT nursing home and dialysis transports. They are mostly medical and require very little first aid. We require RNs, RRTs and Paramedics applying for transport to have 2 - 5 years of experience functioning at their higher credential level. We don't care how long they were a CNA, CRTT or EMT. There are a few drawbacks to just working an ALS transfer truck or CCT epecially if it has limited protocols (CA again can be an example). The IVs, medications and airways will already be established. I have known Paramedics working these trucks that have not started an IV or intubated in several years. Some may require an RN (or RRT) to accompany. Some IV medications will be a "look but don't touch" situation as in various areas Paramedics are not allowed to titrate drips on IFTs. Also, if you are in California I would suggest that you move to another state if you want any chance of getting the opportunity to be part of a decent EMS or IFT team.

You can also attend some national conferences and monitor some of the critical care websites for opportunities or other classes. It also helps if you have some college especially in the sciences like A&P, Pharmacology and Pathophysiology. Do not just rely on the overview the Paramedic textbooks give you for an educational foundation. If you at least have more than just a Paramedic patch and a few weekend certs, the employer might see you are serious. You will need a very strong familiarity with the medications and calculations to where they are second nature. There is absolutely no room for guess work or errors made from not being familiar with pediatrics which can be anywhere from 1 day old to 21 y/o. The same when it comes to airway issues. You must have a strong ability to establish and manage an airway for neonates through adults. IVs will also have to be a strong point if they allow you to do invasive procedures. Critical Care Transport Medicine Conference http://www.flightparamedic.org/cctmc.htm International Association of Flight Paramedics http://www.flightparamedic.org/index.aspx Current Concepts in Neonatal & Pediatric Transport Conference http://intermountainhealthcare.org/hospitals/primarychildrens/classes/classesformedical/conferences/Pages/transport.aspx Conferences at All Children's Hospital St. Pete, FL Neonatal and Pedi conference, Austin, TX http://www.int-bio.com/userfiles/file/2010%20conference%20brochure.pdf Air & Surface Transport Nurses Association http://www.astna.org/ Great Journal: Pedi Critical Care Medicine http://journals.lww.com/pccmjournal/pages/default.aspx Where some of the guidelines originate: American Academy of Pediatrics (AAP) http://www.aap.org/ *****AAP Transport Section ***** http://www.aap.org/sections/transmed/default.cfm

Here are some examples of excellent dedicated pedi teams: Arkansas Childrens (one of the best) http://www.archildrens.org/medical_services/transport/angel_one_staff.asp Children's Hospital of Wisconsin http://www.chw.org/display/PPF/DocID/34487/router.asp Cincinnati Childrens http://www.cincinnatichildrens.org/svc/alpha/t/transport/default.htm West Virginia University http://www.wvukids.com/healthcare-services/ground-transport.html UCSF Childrens http://www.ucsfchildrenshospital.org/services/transport_service/index.html Children's Hospital of MI http://www.childrensdmc.org/?id=1426&sid=1 University of Michigan (one of the first to do mobile neo ECMO) http://www.med.umich.edu/survival_flight/ U of FL, Shands http://www.shands.org/hospitals/UF/ShandsCair/neopeds.asp Wolfson, Jacksonville, FL http://community.e-baptisthealth.com/services/emergency_kidskare.html Arnold Palmer, Orlando http://orlandohealth.com/arnoldpalmerhospital/OurMedicalSpecialties/PediatricCriticalCareTransport.aspx?pid=4943# There are some ground teams that offer a "general" critical care transport as well as some flight services which take all patients. However, the AAP still advises hospitals to use a specialized transport team for peds and neo. There are also some states like CA that will limit what you can do as a Paramedic.

You might get hired as a Paramedic right now but your title would be Driver and with no patient contact. Why pediatrics as a new Paramedic? The Paramedic curriculum barely prepares you for pediatric emergencies for the short term to get the child to the hospital. If you really want to work with pediatrics you would have better chance for a pedi critical care team by getting your RN. Even an RN for many teams needs his/her BSN and 5 years of experience with at least 3 of those in the critical care unit. The same goes for most RRTs. Here is a good article from the AAP which provides the guidelines for Pedi transport. Interfacility Transport of the Critically Ill Pediatric Patient* http://chestjournal.chestpubs.org/content/132/4/1361.full?ck=nck Here are just a few books you might want to study. The list is from the new Neonatal Pediatric Transport exam site which is a very watered down exam. Advanced Pediatric Emergency Care, Jenkins, James, Pearson Prentice Hall, NJ, 2007 AeroTransportation A Clinical Guide, Martin, T, Ashgate, 2006 Air & Surface Patient Transport Principles and Practice, Holleran, Renee, Mosby, St. Louis, 2003 Air and Ground Transport of Neonatal and Pediatric Patients, Woodward, et al., AAP, Illinois, 2007 Atlas of Procedures in Neonatology, MacDonald, LWW, 2007 Comprehensive Neonatal Care An Interdisciplinary Approach, Kenner et al., Saunders, Philadelphia, 2007 Core Curriculum for Neonatal Intensive Care Nursing, Verklan, Saunders, Philadelphia, 2009 Core Curriculum for Pediatric Critical Care Nursing, Slotga, AACN, Saunders, Philadlephia, 2006 Current Diagnosis & Treatment in Pediatrics, Hay, et al., McGraw Hill, NY, 2007 Egan's Fundamentals of Respiratory Care, Wilkins, et al., Mosby, St. Louis, 2009 Handbook of Neonatal Intensive Care, Merenstein, et al., Mosby, St. Louis, 2006 Infectious Diseases of the Fetus and Newborn, Remington & Klein, Elsevier Saunders, Philadelphia, 2006 Kendigs Disorders of the Respiratory Tract in Children, Chernick, Saunders Elsevier, Philadelphia, 2006 Manual of Neonatal Care, Cloherty, LWW, 2007 Maternal, Fetal & Neonatal Physiology, Blackburn, Susan, Saunders, Philadelphia, 2007. Mosbys Paramedic Textbook, Saunders, Micki, Mosby, St. Louis, 2007 Nelson Essentials of Pediatrics, Kliegman, et al., Elsevier, Phildelphia, 2006 Neonatal and Pediatric Pharmacology Therapeutic Principles in Practice, Yaffe, LWW, 2005 Neonatal Perinatal Medicine, Martin, Elsevier Saunders, Philadelphia, 2005 Neonatal Resusictation Textbook, AHA, AAP, 2006 Neurology of the Newborn, Volpe, Saunders Elsevier, Philadelphia, 2008 PALS, Aehlert, Barbara, Mosby, St. Louis, 2007 Pediatric Cardiology for Practitioner, Park, Myung, Mosby, St. Louis, 2008 Pediatric Dosage Handbook, Taketomo, Lexi-Comp, 2008 Pediatric Education for Prehospital Professionals, Dieckmann, Ronald, AAP, 2008 Pediatric Emergency Medicine, Baren, et al, Saunders, Philadelphia, 2008 Pediatric Trauma Pathophysiology, Diagnosis and Treatment, Wesson, David, Taylor and Francis, NY, 2006 Red Book, 2006 Report of the Committee on Infectious Diseases, AAP, Illinois, 2006 Robertsons Textbook of Neonatology, Rennie, Elsevier, 2005 Textbook of Pediatric Care, McInerny, AAP, Illinois, 2009 Textbook of Pediatric Emergency Procedures, King, et al. LWW, 2008 Journals Advances in Neonatal Care Air Medical Journal Clinics in Perinatology Newborn and Infant Nursing Reviews Paediatrics and Child Health Pediatric Clinics of North America Pediatrics Respiratory Clinics of North America Seminars in Perinatology The Journal of Perinatal & Neonatal Nursing

You think 30 is middle-aged? What do you call someone as old as spenac?