EMSGeek

Damn skippy. You're dead on. It is something like 2% of the federal funding available to fire departments is also available to EMS. It drives me nuts when a fire department which does 5 structure fires a year buys a brand new truck with all the bells and whistles every 5 years. One of the few good ways the gov is spending training money is through DHS/FEMA funded classes which bring instructors in to run classes at no expense to responders. We've had a number of these classes in NY and they've been great. The other good spending I've seen is at the Center for Domestic Preparedness and New Mexico Tech both of which provide all expenses paid training but even those programs are almost entirely LE/FD oriented. EMS can benefit from some of the classes but it is clear we are still a bastard child.

Thanks for the help guys...I got my results from the written and I not only passed but actually did very well. I had to retest one of the cardiology stations for my practical but I think that was more nerves than anything else. The second time through that station was a breeze and I got the maximum for points. The other cardiology station was challenging but I knew what I was doing and kept myself calm. Cardiology is still my weakest section but I'm working at it and getting better. I know enough to not kill anyone and keep myself a float in the field. Thanks again guys. I'm now a NYS AEMT-CC...time for the real learning to begin!

Get my NYS Paramedic and NREMT Paramedic. Work in a war zone as a medic. Have enough experiences to write a memoir and then decide if I really want to do it or not. (Translates to: have good bar stories to pick up chicks). Pick a girl up in a bar and seal the deal. Work as a Flight Medic. Become a PHTLS Instructor. Get a bachelors and masters degree. Clear 250K in a year.

If you or your partner are immediate danger use force up to the level of force being used against you and then evacuate the area. You have a responsibility to keep yourself safe, then your partner, then your patient, in that order. If you need help but can hold the situation down for a bit call for law and let them do there magic. As far as specific methods I've found that triangle bandages in a four point approach works well. A straight sheet folded to approx 2' wide and secured across the torso helps minimize the damage the pt can do to their wrists. This prevents them from bucking their shoulders a lot. When securing hands if you can secure one low towards their waist and one towards their shoulders it creates a little muscle discord making it harder for them to fight.

I start my Paramedic in August. I am taking CC because I am able to work as an ALS tech while in the Paramedic program...more money and more options. The importance of paramedic vs CC is not lost on me. Thanks again guys for all the info.

Thanks for the responses, guys. Rhthym strips only...my region still doesn't have 12 leads for the most part...my agency is getting them by the fall (hopefully). I just ordered the Rapid Interpretation book and will start working on it when I get it. I've already started looking at every strip I can get my hands on....that is helping a little and I'm sure with practice it will get better. We definitely have only a cursory understanding of the heart...the CC program (mine especially) is heavily geared towards technician rather than clinician...here's a problem heres how we patch it in the field now go take the state test. I'll keep working on it. Thanks.

I'm in a NYS EMT-CC class and we have basically finished our cardiology unit. For better or for worse we have been left with the basics of cardiology and now must internalize the information. I'm struggling with telling the differences between the various blocks....is the best way to learn just to look at strips and memorize the rules/characteristics? Are there any online resources to help learn? I've tried a couple that I found through google and the MedicCast but nothing has really helped yet. Any dynamic rhythm generators available online? Thanks.

Thanks, Doc. That takes care of my questions.

Thanks Doc. I was looking for a definitive answer and you got it. Is there an actual certification for EMT-T anymore? I realize there are respected schools out there but can one use the title of "EMT-T" after them. My department has asked about a "certification"...it looks good on paper.

Does anyone know what the current status of CONTOMS is? The CCRC website doesn't seem to work and I've googled CONTOMS enough to know there isn't an easy way to find it. I went through the UHS and DHS websites and haven't found anything about upcoming classes. I even thought to look through FLETC but didn't get any results there. I know CONTOMS was having some funding issues...did it get cut? Anyone know if there are CONTOMS classes being run in 2008? I am eligible to take the class as part of a PD ERT.

Regarding the original post of where there is a "bridge" program for CC to Paramedic, the only one I'm aware of is in Utica, NY. Here is the link: http://midstateems.org/class/emt-cfr-aemt.htm Go all the way to the bottom of the page and it is the last entry. Good luck.

Mixed martial arts and bowling. But not at the same time. That would be bad.

So the bottom line is that several of these TQs are good items but each one has certain advantages and disadvantages? What would you guys recommend for each member of a police Emergency Response Team to carry in their individual trauma kits? These guys have basically no medical knowledge what so ever but would need to apply the TQ themselves as the EMTs involved with the team do not go in with the team.

I am a EMT-B currently researching medic schools who has had several friends recently finish critical care tech or paramedic so I've got a little incite. 6 months is the shortest amount of time I've seen for a field experience requirement. From what I've seen the best medics have a decent amount of time in the field as a BLS provider. Any medic worth their salt will tell you that good BLS goes before ALS so having good BLS skills is essential to becoming a good ALS provider. What I've been told by older medics for my own situation was that the best bet is to go from BLS to Paramedic in one shot.

How does one transition a volunteer service to a paid service then?

In the past 5 years we have had only a few people who did not continue in emergency services. Would you discount people who went into Law Enforcement or Emergency Management but stayed current in EMS? What about people who took other paths but continued to volunteer as EMS providers? The problem isn't the commitment to the corp it is simply the fact that our school can only keep people for 4 years really. One can have a service of people who act professionally without having a paid career service.

Sanfu, it sounds like you guys have a hell of a service going. I'm impressed. I wish we could go ALS but unfortunately my school only has four year degrees and we can't keep people long enough to get them through basic and an ALS program. How many members do you have?

Anyone got anything on topic to continue with?

Hey spenac great contribution to the discussion. You really nailed the topic on the head. /sarcasm. Did you even read the topic or do you just enjoy being an a##hole? Spenac, you bring up another topic which is fair to discuss but this isn't the thread to do it.

Safe: As in the educational sense of safety that one has a safety net. Our new providers know that for the beginning of their time as an EMT with our agency they will have a more experienced provider backing them up. Little things such as tricks in dealing with an upset patient, the best way to document a call, etc. Dust, with all due respect I believe you may have forgotten what it is like to be a brand new EMT-B or if nothing else you may be unfamiliar with how little the current EMT-B curriculum teaches things like the finer points of documentation. As with any skill you may learn it but you still need to practice that skill and to practice it effectively you may need some guidance. Crew Chief/Lead Medical Provider: Our crew chiefs are in fact "just" more experienced providers, people who have more time with the squad. I don't even see why you raise this as an issue. Who would our crew chiefs be if not more experienced providers? Part of this is simply the fact that those individuals know the policies of our agency but more than that they have a greater base of experience to draw on and have shown leadership with in the agency. Coming from a paid agency all of the EMT-B and Paramedic supervisors I know are simply people who have put in the time with the agency. Why is this a problem? Bringing it back to the safety issue a provider who has run more calls than another newer provider may have incite into a given problem based on their experience. After getting punched in the face while treating a diabetic patient I have a different view of scene safety. At that call there were two LEOs, three ALS providers, and two EMT-Bs none of which could predict what the patient was going to do. I've learned from that experience and will treat altered patients with a greater degree of suspicion in the future. Experience does count for a lot but all of our providers will still be humble when dealing with a more experienced provider because we never forget we are new to this business. New providers on their own: You misunderstand me. I'm saying that the way my FD does it is not right. There is no reason a brand new EMT should be tossed into the back of an ambulance and have to work a traumatic arrest. In theory they are capable but in reality it takes a little time to develop one's own way of dealing with an emergency scene. I won't be bashful in saying that I think we have the right idea on campus regarding easing people into EMS. I'm glad that I was able to get some experience on campus in our system before I volunteered or worked elsewhere. Teaching/Training: We do drills twice a week on a variety of topics as well as the teaching/training that goes on in the field. I teach some of the classes but I'm not just spouting information. I come up with an objective for the lesson and write out a lesson plan. I use real resources such as EMT textbooks, the AMLS text, the PHTLS text, ACEP content, JEMS articles/references. I'm not an expert therefore I have no right to present this information on my own. I combine information from various resources and present that to our corp. Additionally we bring in guest lecturers such as paramedics, doctors, LEOs, pharmacists, etc to assist with training. Our consistent adviser is a Paramedic who has been in the field for 36 years. He is the individual who helps guide us and who I use as a resource as well. My question to you, Dust, for a volunteer agency with a fairly small training budget (you'd laugh if I told you) who would you deem to be appropriate to be educating? I hope that this cleared things up a little.

We give our new providers a safe way to learn EMS in the field. When someone gets their card they become "Attendants-in-Training" (attendant being the crew chief/lead medical provider) during which time they work with several different attendants but run the calls themselves. This acts as a safety net of sorts because if they need help they have it. I know that with my FD we are hurting for medical providers so bad that shortly after they get their card they are let loose into the field on their own. We try to promote positive habits in the field including good scene control, good documentation, good leadership of a crew, and in general running smooth calls. We acknowledge that we do not have a high call volume and encourage our members to work/volunteer at other agencies. The things we try and teach our providers should serve as a foundation.

I did as the medic told me to. I'm just asking why he would have increased the rate so high. Is this part of an ALS protocol? tniuqs: If I understand your post correctly, let me clarify. The Pt had been diagnosed by a doctor several years prior with WPW syndrome and told us so.

Most of the posts seem to be regarding lowering O2. I have a question regarding upping it. I recently ran a call where the PT was a 21 M with a hx of Wolff-Parkinson-White Syndrome experiencing 5 on 5 chest pain. Since the call I have looked up Wolff-Parkinson-White Syndrome and understand the basics of it. When the medic got on scene he told me to up the NRB from 15lpm to 25lpm and then had the pt preform a vagul maneuver before the ALS crew initiated transport. Can someone explain the upping of O2? I'm not questioning the medic but I'm curious because isn't there a point where the body won't get more O2? Thanks guys.

I too am part of a collegiate EMS agency. We are a transporting BLS agency which services our campus, off campus students, and has agreements with the surrounding city and town to provide an additional BLS bus should they need it. We are entirely volunteer and run approximately 350 calls a year. I think collegiate EMS is a great place for people to learn about EMS who might otherwise not get involved. Our corp. is a training corp in the sense that we try to give our members the skills to succeed both on campus and elsewhere. I volunteer with a FD and work for a paid ALS service when at home and between those two agencies I can see that the way we train our members on campus is pretty good because we have the luxury of time to train. We don't give our members any additional medical skills but we do try to get them some positive experience in the field. I think everyone will agree that there is a big difference between a green emt and a more experienced provider even if they are following the same protocols.

Sometimes it certainly seems that way. Protocols, procedures, and quality care seem to be things which their authority doesn't value.