VillageEMT

Arron, Trade you for a week, just come to Owego on a Wed., otherwise known as CPR day. Five of seven full arrests this year have been on Wed., which just happens to be my crew's day. :shock: People ask why I do this for a living. "For a living!" I say, "HELL NO, I do this as a volunteer." Then they know I'm crazy. "It is better to keep your mouth closed and let people think you are a fool than to open it and remove all doubt." Mark Twain

Mostly black, from the first day, CPR -> DOA times four in the first five weeks as an EMT. :shock: But things are improving, the latest code is still alive a month later. Maybe it's because our new crew member is also a black cloud and we cancel each other out. :wink:

Welcome aboard! You are not crazy or at least it's a good kind of crazy. I'm 55 and started only last year as a volunteer. It's never too late. One of our EMTs upgraded to paramedic just last year, he's a retired engineer. The Fire Dept. paid for my training at the county EMS school, so think about who is going to advance your career when you look for a job. Many places will pay for you to improve your skills, but some will not. Class is only the beginning of your training. A Basic in NYS needs 72 hours of Continuing Medical Education (CME) every three years to recertify without a refresher course. We also require skills testing periodically. Your mileage may vary. We were required to have 10 hours of "clinical" time for our Basic class. This could be either in an ER or in the ambulance. The ambulance time only counted if you went on a call with a preceptor and transported to the hospital. Each call only counted as one hour even though our average call time is two hours plus since we are 25-45 minutes from any hospital. My 10 hours of clinical was really about 25 hours, with a major trauma case thrown in for good measure. Think about running with a local EMS as a volunteer or observer if they will let you. I started driving for our squad before taking the EMT class and learned a lot. (I also learned that I love doing this and could cope with all it involved.) It also helps to know who the local people are and how they work. Gender issues don't seem to be a problem for us, we are pretty evenly distributed between men and women. After the squad elections next month, I expect that the new co-captain will be a woman who is now our lieutenant. Our squad is volunteer, but some of our EMTs also work at local hospitals and on other, paid EMS services. EMTs in the ER are becoming more common these days. The hospitals have figured out that they are cheaper and have better trauma and CPR skills than many RNs. It's a different prospective from nursing, your concerned with the first hour of care. Good Luck!

We just got Albuterol and Epi-Pens for the BLS bags on all our rigs. We normally run ALS but there are times when we respond BLS to an allergic reaction or a difficulty breathing. If it's the first call we will have an assigned crew with ALS, but a code 2 call you go with whoever comes and ALS can come later, if required. We run on the priciple that a good outcome is more likely if we can get treatment started sooner. My view is that the first two or three minutes of a call is almost always BLS anyway. ABCs, O2, assessment, the sooner the better. I guess that we are lucky, from what I have read here not all squads have such "enlightened" ALS.

emt_hound We don't charge anything and we are volunteer (except for two paid Ps weekdays), but we have Lifepak 12s, CPAP, etc. We have a very solid in house CME program and members are encouraged to attend additional outside CME training at Squad expense. In addition we train the local PD in CPR/AED with our own AHA Certified CPR Instructors. I don't think that charge or no charge governs the quality of care. It depends more on the community's attitude toward EMS and their willingness to support it and most of all on the people involved. For a service area with about 26,000 people we have three ambulances, a fly car, 32 EMTs, more than a third of them AEMT-CC or AEMT-Ps. We almost always run with at least an AEMT-CC in charge of a four person crew. We have had some in the community asking why we don't split away from the Fire Dept. and charge, but that idea never gets anywhere, because what we have works so well.

The variation in gravity due to the position of the moon is about one part in ten million. You can get the same effect by moving up about one foot in altitude. Sorry, but the unless all the crazies loose it when they go upstairs we need another explanation. We have our worst accident days when the sun comes out and breaks our usually cloudy weather pattern. A lot of people around here just can't cope with the sun. Of course there are always Friday night, Saturday night and Sunday night. Unless it's CPR, that is the Wednesday night specialty here. ;-)

It's hard to believe that our little village is more automated than NYFD, but ePCRs are the norm up here. The SREMS requires them. We have a paper "call sheet" that we use to record the basic information. This gets inputted into the laptop in the rig and transferred, via floppy, to the server. The server gets backed up remotely on a daily basis. The system faxes a copy to the ER when we commit the PCR. It works very well, even though the user interface is a bit clunky. You have to have all of the required fields filled in to commit it, so that much at least is covered. There is a drug look-up dictionary and a spelling checker, both essential for me. I had to do paper PCRs for my clinical runs and hated it, ePCR is much easier. But then I've been working with computers for... well let's just say a very long time. Hey, where is the punch card reader on this thing...

We have Hazmat Awareness as part of EMT training and as part of continuing education.

Pads on all of our AEDs. Two of the rigs have Lifepack 12s and the third has a Lifepack 10 and a Lifepack 500 for the Basics.

We cover about 100 sq. miles of hills and valleys with a population of about 26,000. Our coverage area overlaps four townships and a bunch of villages. The dividing lines between districts have been worked out over the years to cut response time rather than distance. Around here it's faster to go 10 miles on a main road than go 5 "over the hill." We have two ambulances and a "fly car" at Central Station, our ca. 1911 firehouse. There is a third ambulance at Station Four across the river. All of the rigs are ALS equipped. Weekdays 5 AM to 6 PM is covered by two paid Paramedics with volunteer drivers and sometimes volunteer EMTs for crew. The rest of the time it's all volunteer. 30 EMTs with about a third being EMT-CC or -P. The heaviest call rate I've seen was five in about 30 minutes Xmas eve. We had to call for mutual aid for ambulances but we answered all of them. The Wed. before we had 13 calls during a rain & ice storm. The "normal" day is more like 4 to 5.

We are a volunteer squad but we still have assigned shifts for the primary crews. If you don't show, it gets logged as a No Show. If that becomes a habit, you are warned to change your ways. If that doesn't sink in, you're history. It may sound weird, to "fire" a volunteer but the other crew members and the public count on us and we have to be there. I hope you have your documentation in order, this could get ugly if he wants the make a case out of it. Keep up the good work on improving your agency, it's the thing I like best about our Captain. We don't get paid, but we do get the best training and equipment we can afford.

They are in the NYS BLS protocols for shock and unstable pelvic fx but they are rarely used. We can use them on a standing order if the BP is below 50 or if the BP is below 90 and there is an unstable pelvic fx. We were told that they are loosing favor in EM and may go someday.

I ran my last 5 K about ten years ago. At 6' 2" and 170 lbs. I'll never be fat. I never was a marathon runner, the 100 yard dash was my big thing. My best was 9.9 sec, when the world record was 9.6. I can still manage a respectable 7.5 minute mile. OK 8 minutes. Still not bad for a 55 y/o. "Experience and deceit will always defeat youth and strength." Anon "It's not the years, it's the mileage." Indiana Jones

We rarely see doctors in the ER unless we have a major trauma or CPR. Then they are all ears and want to know exactly what happened and what we did about it, STAT. If you are ready with your report all is well. We make a point of always being ready. Our Medical Director is an ER doctor and is very supportive of our efforts to improve the service we provide. When I did my clinical time the ER was packed. My Nurse Preceptor had four cardiac pts so she just told me to take the next pt who came in the door and follow them through the whole process. This was just what I had wanted to do, so it worked out great. When the doctor and resident came around they started to examine the pt and I filled them in on some details which were not in the chart. They must have seen my "EMT Basic Student" badge (I was in uniform as well) but they included me in the treatment discussion as a matter of course. Later, the resident came back to check on how the treatment was going he asked me for my observations as well as talking to the pt. Sometimes it helps to be 55 with iron gray hair and a professional demeanor, even when you are only an EMT Basic Student.

All of our EMS people belong to one of the fire companies, but many have not functioned as firefighters for years. The Rescue unit is Company 2 AKA "Susquehanna Hose Company". Tradition plays a big part in our dept. We beat the chiefs to a house fire recently and got to call in "smoke showing." Then we had to pull hose from the first responding engine because it only carries two people. It's the first time I've done anything as a firefighter in 6 months. Then we stood back and just did rehab as needed. More than 90% of our calls are EMS only calls.

We have two paid EMT-Ps on weekdays (5AM-6PM) with vol. drivers. Nights, weekends, code 3 (third calls) are all vols. Fire has been all vols since the beginning, 1828. With 1800 calls a year, 90% EMS.

"You carry a deer rifle during deer season, just in case you see the "big one." " Who needs a rifle. We go hunting in any season with a Ford 450 Automatic.

We are right in the middle nowhere. Any hospital is 20 min. plus and even a helo takes 10-15 min to get here for a pick-up. If we are out in the hills it could be 10-20 min. more and no helo if the weather is bad. That's why we usually run with a AEMT-CC and two or more EMT-Ds. ER?, we are the ER for the first half hour at least. There's nothing like having four in the back for CPR or major trauma. Luckily, at the end of the run there are two good trauma centers waiting for us. If we get them there with a pulse they have a really good chance.