njmedic1485

Okay, for the record this happened in Northern New Jersey, which, as everyone knows bears no resemblance to the rest of the state.

Based on what Lone Star posted, I don't completely disagree with the company's position that this medic should have been able to work within that 60 day grace period. The license doesn't "lapse" until after the grace period.

My personal opinion here is that you kinda jumped the gun a little bit on this one. It wasn't really your concern, and there is a chance you were wrong anyways. It isn't your responsibility to police the certifications and licenses of everyone you work with, and without knowing all of the details it seems a bit over the top that you would go as far as to resign to make your point about it. Turning in an official complaint to the state at this point seems to me like sour grapes.

I think Fiznat misinterpreted Lone Stars post. The License lapses after a grace period, which means it is ineligible for renewal. The second paragraph pretty clearly states that continuing to work with an expired credential is a felony under Michigan law.

f your license is not renewed on or before the expiration date, you have a 60 day grace period after the expiration date to renew with paying an additional $50.00 late fee for a total of $75.00. If it is not renewed within those 60 days, your license will lapse.

If your license expires, you cannot practice your profession, nor will you be able to identify yourself as being a licensed EMS professional. Working without a valid license is considered a felony under Michigan Law and will result in legal proceedings.

Secondly I've got to take exception to Fiznat's personal opinion that having knowledge of a company condoning the continued practice by individuals with expired credentials. It seems like a recurring theme on this (and many other) forums is the lack of respect that EMS is given by other health care professionals. Could it be that one of the reasons is that we refuse to police ourselves? What do you suppose is the ANA's view of unlicensed nurses working, or that of the AMA on unlicensed physicians? I have no illusions that this one issue will be the golden key to respect from our fellow health care providers, but shouldn't this be a start? "If not us, who? If not now, when?"

To the OP, make the call.

My department tried to save a little money one year and switched to plastic disposable laryngoscope blades. They tended to get soft and bend in the heat and got brittle and snap in the cold. I snapped one trying to intubate a little kid who got ejected from her mom's car on the overpass and landed on the road bed below.

No way the EMS team should be disciplined.

from

Carn evil 9 - Emerson Lake and Palmer

"Welcome my friend to the show that never ends" It's been that kind of night. Regrettably, the 7 virgins and a mule were a no show

You should also take a look here

This is a blog written by Tom Bouthillet it's a pretty good read, and if you start from his first post it's a comprehensive review.

Really? There are a few things that I like about the Lifepak more than the MRX, but overall I'd prefer the MRX. What issues do you have with it?

Mrmeaner-

Physio is all we've ever used so I'll admit to having a bit of a knowledge deficit about the MRX. Can you enlighten me as to what you think makes the MRX superior to the LP12.

This story is not too far off true. I used to work in a casino in Atlantic City I remember back in the early 80's there was a male /female team that would specialize in rail theft ( stealing chips from the rail of a craps table). She was generously endowed and would flash the table while her partner would scoop the chips and run. I remember when we got hit, some of the old guys at the table weren't too upset at the monetary loss. they just enjoyed the show!

We are allowed to access AV shunts as an absolute last resort (medical control option) access, we carry the same needless that the dialysis centers use and include the procedure in our yearly education/skills day. I've done them a couple of times but only during codes. The dual port subclavian ports they put in as temporary accesses until the grafts cure are much better. Just aspirate 5 ml and waste then flush with saline and your good to go. And yes our nephrologists go ape sheet when we access them.

For the uninitiated an AV shunt or graft is a goretex tube that joins a vein and artery in a patients arm. After the graft is in place it needs to "cure for 6 to 8 weeks, this allows a layer of epithelial cells (I'm pretty sure I misspelled that) to grow over the graft, that cell layer is what clots off after being punctured. To assess a graft for patency; palpate and auscultate, you should feel a definite pressure difference even in shock states (not so much in cardiac arrest) and you should hear a nice loud bruit. We are taught not to stick on the loop of the graft and to avoid any recent sites, our insertion angle is steeper then a regular IV stick then you rotate the needle 180 degrees and flatten your angle as you advance the needle into the graft. This is supposed to stop you from going thru the graft.

And a current one.

I would say that age is not as important as maturity in making a good paramedic, or EMT for that matter. Is it possible that the "old head" was trying to teach you something and all you are picking up is the negativity? Please don't take this as a put down, I don't know you or your situation, just playing devils advocate. I do recognize the possibility that you ran up against someone who really has 1 year of experience 22 times but dosent realize it.

DJ-

First off, ALS in New Jersey is all hospital based, mostly intercept work. In order to qualify for reciprocity you have to be sponsered by one of the hospitals. If you have a vaild national registry card you can be granted a temp certification number that is good for 6 months, at teh end of that time the hospital either withdrawls sponsership and you loose your NJ card or they approve of you and the state cuts you a two year card just like the rest of us. Pay rate depends on the hospital, but where I am it ranges from 18.00 - 32.00 / hour. If you'd like more information PM me, we are hiring full timers.

I was taught a version of this and it was helpful. I found this version in the blogosphere at JBontherocks.blogspot.com

"If the P is far from me,

The block is known as First Degree.

"Because farther, farther, farther, drop

Will then be called a Wenckebach.

"If it's P-P-Q and P-P-Q,

This you call the Mobitz 2.

"When the P and me do not agree,

Then we've found the Third Degree."

e-mail sent

UMSTUDENT,

Do you have the opportunity to follow up on patients where you work? If I've got a patient that I'd really like follow up with, I just write down the basic info and one of the nurses or docs will look him/her up in the system later on. This has helped me quite a bit. It is nice to hear "how things turned out" and to apply that experience to the next patient. It is up to the individual medic to find out for him/herself, though.

Fiznat,

Getting follow up information back to the line troops one of the biggest ways to get buy in from the field, I can get information back with in 24 hours and our director publishes our STEMI alert times quarterly. It is an acceptable disclosure under the HIPPA QA/QI and education exemptions.

As a side note to anyone else using the LP 12, do you routinely leave the chest cables hooked up to take advantage of the trending capabilities?

Reaper, your system is obviously more advanced than mine --- how does the location of the MI change your "field" treatment ?

Also with a confirmed STEMI I think more about adding some Lopressor.

When the Elephants go to war, only the grass gets injured

This is also one of my pet peeves. Everyone should be adressed as by thier surname with the appropriate title. Most people will readily agree to a more familiar form of address, but I think it's respectful to get permission first and that is the first lesson for all of my ride alongs. I did run into a similar situation recently, one of my son's friends from high school recently became a police officer in a nearby town. As luck would have it we wound up on a job he was first responding to and he adressed me as he always had "Hi Mr. Jester" (he was a very polite kid, I'm glad to see the academy didn't break him of that). I told him it wa okay to call me Bob, he said it just didn't seem right. I felt old that night.

Once Upon a Time in the West- Dire Straits

Any personal or familial history of unexplained syncope? If a 12 lead was done does it show a long Q-T or any S-T segment abnormalities? I imagine any shot hard enough to precipitate v- fib could cause myocardial contusion. If the kids heart rate and BP normalizes on it's own I don't really see the need for an antiarrythmic. Some oxygen, an IV line and a little cautious monitoring sounds right to me.

That's a classic Reaper-fusion arrythmia

Take it, today's my 44th birthday and I'm hammered, gonna need some in the morning

Leave a piece of birthday cake Italian rum cake

It's hard to believe that I made my first official ambulance call 25 yrs. ago on this day. The day before my 18th birthday, the state gave me the one day.

In nine days it will be 25 yrs. when I ran my fist code.

I hear ya Fire Doc, 17 October will make 27 years for me. It's weird, with all teh advancements in patient care, I still find my self falling back on the things I learned in Boy Scout First Aid.

Of course, if you are going on that fishing trip early in the morning, you stay up all night running too.

You can sleep the night before a fishing trip? I usually get a solid 10 minutes the night before a trip