noahmedic

I've had several partners say this to drunks we've had to pick up when they hear how much they've had to drink.

You've found someone who actually admits to having more than two beers?

I'd be shocked if more than five percent of those who offer an opinion have actually used both models enough to judge.

People just go with what they know and stick with it. Otherwise, Lifepak would have gone out of business a long time ago.

Exactly, I've always used LP12's, so that's what I feel comfortable with. Is the M-Series better? Maybe, but I can bet I won't like it at first. I use an MRL PIC 50 now, and that took me awhile to get used to as well.

I try to be diligent with gloves when I'm working with a patient, but there are times I just work with my bare hands, like doing a quick BP or taking a pulse. My skin comes in contact with far more people on the subway on the way to work than when I'm actually at work. I don't mind getting my hands dirty, but I am sure to get them clean right after wards, if all else fails I do a quick rub down with alcohol preps. If there's bodily fluids around, you should have gloves on, that's common sense, but I'd say be more diligent about washing your hands then making sure your gloves are on at all times. We have these extra thick rubber gloves that are good if you are banging around, they are very hard to tear, but doing delicate procedures with them is a real challenge. Our IV start kits come with a pair of sterile gloves, and when I'm doing an IV I always change into them before proceeding, not to fool myself into thinking that I'm going to be doing a sterile procedure, but at least they are cleaner than the other gloves I was using, and they are much easier to work in. This brings to mind a question I was debating with my partner. Say you have a long sleeve uniform shirt on and you are working on an actively bleeding patient. I have a tendency to pull my sleeves up to keep them out of the way of anything oozing. Now, my partner asserts its better to get it on your uniform shirt then your bare arms, but me, I honestly think that if you clean it off quickly its better to get it on your forearms than your uniform. If you get it on your uniform, especially a dark one like mine, you may not notice. In addition, if it seeps through, it is trapped by the cloth next to your skin for a prolonged period, unless you want to do a strip tease in the back. I don't mind getting blood on me. Yes, I ideally, I should be wearing a disposable gown if the person has a bleed, but falling short of that, which do you think is better, on the uniform or on your arms?

On your arms, definitely. As long as there are no open cuts your fine. I feel the same way, but I always wore white uniform shirt, so if I got stuff on it, it was just gross looking.

Noah

Like asys, I have had residents do ride-alongs once in awhile. They are always great, no problems that I can remember, they normally stay out of the way though unless we tell them to do something particular. Here is the US it would not be the best use of resources to have an physician on every transport.

Noah

The Arizona Dept of Health-EMS has the rates for all their air ambulance providers on the website, sorry you'll have to google it, don't know it off the top of my head. Anyways, even though we may charge $6000 for a flight, we may only collect $2000 from insurance, and we do not bill the patient for the remainder.

As a side note, how about we look into reducing the number of HEMS accidents before we go looking at ways to make it worse. Can you imagine that poor EMT/pilot you're proposing having to choose between pt. care and flying the aircraft if something goes wrong?

Noah

"Off duty?"

What is this "off duty" concept you speak of? :?

I was just thinking the same thing! I do keep a first aid kit in the car though, but that's more for when I do something stupid and need a band-aid. When I'm actually off-duty I don't stop at accident scenes.

Noah

I enjoy it, but then again I've never really done much else. I did work retail when I was in high school, not fun, no way I could do that for the rest of my life.

Noah

This was actually a fun 15 min project for me, I really need a flight! I got to empty all the pockets of the flight suit and see how much crap I actually carry. Way more than when I did ground.

-Company Pager

-Company Cell

-Personal Cell, because cell coverage where I work sucks, so if you have a pager and 2 cells from different companies then dispatch might get a hold of you

-pens x4; I normally carry the company pens and drop a few off at the referring hospitals, it never hurts

-steth

-business cards, to give to family members who ride along and want to pass along what happens with the pt.

-gum

-granola bar (sometimes we can go a long time without eating!)

-iPod, those flights back to base can be boring

-pocket reference of company protocols, this also has all sorts of phone numbers, gate codes, etc scribbled in the back

-gloves, I hate digging these out of bags, or stealing them from the referring hospital

-ID/cash

-shears

-sunglasses

When I worked ground I didn't carry half this crap. I let it in a bag on the ambulance, or it was in with the rest of the gear. When I worked ground I was lucky to have

-pager/radio

-steth

-pen

-gloves

That's EMS for you. I felt lost my first few months too, but then again I felt lost when I moved from a 911 service to fixed wing critical care transport too. It's just a new job and it will take you awhile to learn the ropes. Hopefully you have good medics who you can learn as much as possible from. They can be a great support for you while you're in school, take advantage of it.

Noah

Ok, well glad you have an appt. Anyways, I guess I'll elaborate a little then. I actually paid cash for my EMT class, but it was really cheap (like <$500) because I took it at a tech school, but I do have a B.S. in Bio so I've worked the finacial aid system myself. Most EMT-Basic classes only quailify as 6-8 college credit hours, so that's part time. If you want to get the most finacial aid you need to be attending full-time, or at least 12 hours. The best student loans are subsidized Stafford loans because the federal goverment pays the interest. I'm with Rid, take a few add'l classes, I'm sure the admissions counselor can recommend a few that will work toward a degree with EMS. HAVE FUN!

Go to the college's financial aid office and make sure they are including loans in your financial aid package. It's really that simple. The counselors in that office will be able to tell you everything, and if they are not able to get you government-backed loans they can point you in the right direction for private loans. The answers you get from them will be 10x better then those that we can give you.

Pt. assessment is #1 in my book. I don't care how good your "skills" are, you can't do anything with them unless you can assess your pt. My best advice is to practice, nothing else is going to help you out. Find yourself an instructor and have them help you.

Fiznat, to answer your question, I look at it as an expansion of experience that I just wouldn't get in a ground job. I still work the ground. But there are things and patients and challenges offered in my flight job that I just don't get on the ground. Not to sound too altruistic but there is a certain satisfaction in that (well, that and the chicks dig a guy in a flight suit and helmet ).

And Noahmedic's response on the supply and demand aspect apply, too.

-be safe.

I didn't think about that, but the "expansion of experience" is also true. I've learned so much about in-hospital care doing critical care interfacility transports. And chicks really do dig a guy in a flight suit. :wink:

Noah

Man oh man. How do you guys reconcile these points

...With these?

Actually it's very true! Most employers know that there are 100 people waiting for flight job if someone quits. Of those 100 maybe 10 are qualified, and maybe 5 are actually a good fit for the company. So its a buyers market if you will, simple supply and demand at work.

All the things Rid said are 100% accurate. I would add that you may be able to do a third ride program with some services, not a bad idea if you are curious about the field. This normally is easier to acomplish with goverment or hospital-based programs, but some private companies may be willing to let you ride along too.

Noah

Well I'm a "flight medic", but once again, we do not have any special patches. I work on airplanes(fixed-wing) though, not helicopters(rotor-wing). We just wear embroidered flight suits and our name badges. Flight programs tend to prefer pins over patches, but once again my company doesn't do those either.

When I first started for my current company I literally fell out of the plane as we were unloading the pt. I guess I hit my head and lost consciousness, because when I woke up I was on a backboard and my partner was trying not to laugh (damn nurses!). So they wheeled our pt. into the hospital and I was taken in right after. The ER staff was smirking and trying not to laugh themselves. All I was thinking was, "There goes this job!", but I was taken back into the fold, yet I'm always told to "watch my step", and "look before you leap!". It's all in good fun, but boy was it embarrassing at the time.

Almost the same old gold disco ball! They call that a redesign? That picture on E-Bay looks really, really sparkly.

"44% Dixie. Barely in Yankeedom."

I think Arizona has been rubbing of on my good old okie ways! My mom is from Boston though, so I've picked up a lot of strange things from her.

Former (I work there occassionally as a prn medic now) EMSA-Tulsa medic here too, it was my first job as a basic and then I moved up as a medic. Anyways, what everyone else has told you is true. I enjoyed my time there for the most part, but I tried to stay out of the political and managment aspect of it as much as possible. I enjoy SSM and the posting thing, keeps life interesting, but being in an ambulance for 12 hours can really drive some people crazy. If you any specific questions let me know!

Short answer, NO! I would suggest you google for the answer, and read exactly why. I will help it stick in your head more if you look it up and read it.

Nothing personal against EMSA, in fact I still work there on occasion. In fact, I think EMSA does a great job providing high quality care to the citizens of Tulsa and OKC and they sure are not recognized in the local area for it enough. As far as turnover goes, you are correct, it is bad in any part of EMS, even where I work now we a turnover problem with nurses. Regarding the "public servant" attitude, I for one do not view myself to be a "public servant", I am a medical professional. My issue is not with EMSA it's with the concept of the PUM, and the fact that several aspects of it do not work as advertised.

As far as Fire taking over EMS, at least in Tulsa I can tell you that will never happen. Tulsa fire is not planning to hire and pay any more people for their paramedic level skills. The small amount of time between when fire arrives and when EMSA arrives does not warrant having a medic on every fire engine. As a side note to this EMSA has allowed MedSupport (wheelchair/stretcher van service) to do some of the more routine transports that do not require ALS care, I'm sure this has eased the burden of some of the nursing home and hospice transports.

I agree with Rid on AMR, you hear good and you hear bad, but ultimately you will probably have to go to work there and decide for yourself.

I could write a thesis on the downfall of the PUM for EMS, but it does have one upside, it separates EMS from Fire. I agree with Dust, I feel it creates a more professional organization, but the 12 hours stuck in a unit are hard, and sometimes very, VERY boring. I know that EMSA (well actually Paramedic Plus ) has a very high turnover rate, but it seems like every EMT and Paramedic in Tulsa has worked @ EMSA sometime. Sorry I can't tell you much about AMR, but I do know a lot about the pros and cons of the PUM.

Actually AMR was never in Tulsa or OKC. EMSA is a trust EMS (Emergency Medical Services Authority) and was operated by Seiko management group before the current management.

R/R 911

I was thinking the same thing, but then most people outside of Tulsa & OKC don't really understand what EMSA is anyways. For the record EMSA is currently managed by Paramedics Plus from Texas. Does AMR even bid for the EMSA contract?

OK, for the OT part. I leave for 7 days and there are 693 new posts. WOW, that's a lot to look through.

I want to clarify and expand a little bit. The #1 reason I do not report everything to the police is patient-provider trust. If my patients think I'm going to run to the police with everything they tell me I doubt they would be willing to divulge much. Of course, we already have this problem, our patients already lie or withhold potentially important information, but why reinforce it?

I would note the presence of drugs on my chart, it could be part of his history after all. I would ask the patient if they have recently used anything, and note that as well. I would not call the police in and report it.