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swn919

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Everything posted by swn919

  1. I saw that, the final project looks kind of rough. Was it in fact?
  2. I am looking at becoming a Texas EMS Instructor. I am going to be unable to attend the EMS conference this year, and from what I can tell most people go there to obtain certification. I have see a few online places such as Techpro Services offer an EMS instructor course, and I know that the State will accept "Methods of Teaching" along with a written test at a regional field office. I am not opposed to taking this test. My question is for the current Texas EMS Instructors, and it is two fold. How did you meet the education requirements for EMS Instructor? Are there any "Methods of Teaching" course still approved by DSHS? Thanks swn919
  3. I am about to renew my NREMT-P. My question is other then the refresher course completion certificate , CPR, and ACLS do I have to send in the 24 CE certificates with the application, or do I only need to submit those should an audit come up?
  4. We are a Texas hospital based 911 service that bills using the part B protocol. My question is are you allowed to bill for individual supplies i.e. IV caths, 02 masks, drugs? If you are where can I find information on that?
  5. Thanks for your reply, the state is Texas.
  6. I was recently named Director of a small rural 911 hospital based service, with the directive of turning around our abysmal collection rates. I understand when/why Medicare pays and does not pay. However, alot of the staff here does not. I was wondering if you guys/gals know of a QA form that deals with Medicare/caid requirements? If you dont I would still be interested in any QA forms you might be willing to allow me to use... Thanks Scott "swn919"
  7. No those are credit hours, so to get 128 credit hours it would take a full time student taking 12 hours a semester around 4 years to complete. This would include summer sessions
  8. Hello guys and gals, I currently have my Paramedic with an A.A.S. I am currently looking for input on any online EMS/Management programs. Are there any that are actually feasible to complete with all parts of the course online?
  9. This is strictly a fact finding post, I hope that this post can stay civil. To start I have no opinion on the matter that I am about to ask on. I don’t do this, but if you do I say more power to you. Once again please keep this civil. Is there or isn’t there any federal laws stating one way or the other that EMTs/Paramedics can or cannot carry guns while on duty? More specifically are there any laws in Texas that relate to the matter? The question has come up several times in the area(Texas) that I work in, some people say it’s not legal (but fail to provide proof), some people say it is legal( but once again fail to provide proof). So what I am looking for is proof one way or the other. Once again it does not affect me because I don’t carry a gun and if I wanted to I could afford the gun. So if you have any information please let me know. Thanks
  10. 1. I wouldn't say routinely only if something looks out of whack. 2. No, I was not until I googled it thanks for pointing me to something new, and usefull 3. Unfortunately, no 4. BBB, yes the rest no 5. Yes same order each time to make sure I don't miss any thing. 6. Familiar enough to interpret each one except Wellen's
  11. I guess what my main question is. If you don't do the traditional refresher, you are required to take CEs from the Manditory subgroup and from the flex subgroup... If you take the traditional refresher is there and rhyme or reason to the CEs other then no more then 12 hours from any one subgroup?
  12. Ok, yeah that is what I got as well. I pulled this from the NREMT website: 1. Refresher Complete an approved DOT National Standard EMT-Paramedic Refresher 48 hours 2. Additional Continuing Education Hours Additional EMS related Continuing education 24 hours REQUIREMENTS 4. CPR Certification NOTE: A total of 72 hours of EMS education is required to re-register. Requirements for re-registration are listed below. Hours from the above courses can be applied hour for hour with no maximum: Advanced Trauma Life Support, Refresher Course Instruction, and Wilderness EMS Training. Courses That Cannot Be Applied Towards Additional Continuing Education Hours: Clinical Rotations, CPR, First Responder Course, Home Study Programs, Instructor Courses, Management/Leadership Courses, Performance of Duty, Preceptor Hours, Serving as a skill examiner, and Volunteer time with agencies. To obtain locations for continuing education, contact your state EMS office or local EMS training center. Thank you for your commitment to re-registering your certification. NREMT certification gives you recognized credibility across the nation, and demonstrates your desire to serve the public with the highest of standards. Your certification will continue to serve you well during the course of your EMS career. Paramedic Re-registration Requirements 3. ACLS Submission of approved ACLS equivalent to current AHA Guidelines for CPR and ECC. Credential must be current through March 31. Verification may be in the form of a card or certificate. The Paramedic refresher course can be completed through two different options: (1) Traditional refresher course Completion of an approved 48 hour DOT National Standard Paramedic Refresher or CECBEMS approved refersher course. (2) Continuing education topical hours Paramedic refresher may be completed by continuing education* and must include both mandatory and flexible content. See the reverse side for more information. Submission of approved CPR credential for the professional rescuer. Credential must be current through the March 31. Verification may be in the form of an instructor’s signature on the re-registration form or copies of both sides of a current card. The following are maximum hours per course that can be applied towards Additional Continuing Education hours:  A maximum number of 12 hours can be applied from any one topic area.  A maximum number of 16 hours can be applied from each of the following courses: • ABLS • PALS • ACLS • PEPP • AMLS • PHTLS • BTLS • PPC • NALS • AE  A maximum number of 12 hours can be applied from each of the following courses: Teaching CPR • Emergency Driving • Dispatch Training.  A maximum number of 12 hours can be applied from Distributive Education towards this section and must be state or CECBEMS approved. College Courses The following are maximum hours per college course that can be applied towards additional continuing education hours:  A maximum number of 12 hours can be applied from: • Anatomy • Pharmacology • Cellular Biology • Physiology • Chemistry • Psychology • Microbiology
  13. Ok, I have a question. This will be my first time to recert, as a Paramedic for NREMT. I have taken a traditional 48-hour refresher course, this would leave me with 24-hours of CEs to get. ACLS can count for as many as 16 hours, I'm guessing that because my ACLS with just be the refresher course, it will only count for 8 hours(?). That would leave me with 16 hours of CEs left to do. So with that said, and if I'm correct I can take 16 hours from any CEs sub-group correct? Thanks, Scott
  14. Ok did some digging and I found this stuff: Aortic Aneurysm- Many cases of aortic aneurysm have a normal arterial pressure According to Williamson4 blood pressure tends to be higher in cases of simple aortic dilatation than in cases in which a distinct aneurysm is present A pressure difference 5 to 20 mm in the two arms is very commonly found and occurs in about the same proportion of cases whether the innominate artery is actually involved or not. Differences amounting to 30 mm or more occur in about one third of the cases and indicate aneurysm rather than simple dilatation or mediastiual tumor which latter causes inequality of tension somewhat less frequently than does aneurysm Small inequalities of pressure are of little practical diagnostic value Unilateral differences of 10 mm in the two arms without any constancy as to the side occurred in 20 per cent of 36 cases studied by Phipps1. The administration of potassium iodide or the injection of sterilized gelatin which often relieves pain has no effect on arterial tension2. Unilateral pressure differences may also be encountered in arteriosclerosis in hemiplegia and in cases of cervical rib In the last named condition lowering of the arm sometimes produces a demonstrable decrease in the pulse-pressure. 4 Lancet, November 30, 1907 1 Boston Med and Surg., Jour 1915 cIxxiii 476 2 Mackinuon M,: Arterial Pressure in Thoracic Aneurysms, British Med. Jour., October 4, 1913. Sorry for the poor grammer only way I could get it to copy over. If you want to read it for your self go here: Blood Pressure-By George William Norris on page 245-246 The Peripheral Arteries.—The pulse in the vessels beyond the aneurysm b delayed. Hence the two radial pulses may exhibit differences in time. The volume of the pulse beyond the aneurysm is lessened, and in aneurysm of the abdominal aorta or the femorals it may be obliterated. Such differences as these will not only point to the existence of thoracic aneurysm, but also its seat. Thus, if there be dilatation of the transverse arch with no implication of the innominate, the pulse at the right wrist is strong and almost simultaneous with the cardiac impulse, while that on the left side is small, weak, and delayed. If the reverse be true with respect to the pulse, then the aneurysm may be near or involve the innominate. O. K. Williamson has found a marked difference in the blood-pressure of the two arms in cases of thoracic aneurysm, a variation of more than 20 mm. Hg. being in favor of aneurysm. A Text-book of the practice of medicine By James Meschter Anderson Pg. 704 Take these for what they are worth they do of course come from books published in the 1920s. I did find newer books that spoke on this but they are copyrighted and I could not access them.
  15. Ok this is for Texas people. First can you tell me the steps for becoming a certified EMS instructor, I looked on the state EMS site but could not find any information other then you need to take a DSHS approved course or methods of teaching. With that being said is a method of teaching class available online?
  16. Not sure I would do this^^, but I have been in the same situation a time or two. I think that your boss was right and the hospital was in the wrong. They can either treat the pt medically until another unit becomes available or call the bird. What happens when a cardiac arrest is called and the nearest unit is 45 mins away?
  17. Hey guys and gals, I am looking for a general PCR that would be suitable for a basic level(non-transport) volunteer service? If you have one that you could email, fax or know of one online please let me know. Thanks Swn919
  18. Doctors Change the Way They Think About Death The new science of resuscitation is changing the way doctors think about heart attacks—and death itself. By Jerry Adler Newsweek May 7, 2007 issue - Consider someone who has just died of a heart attack. His organs are intact, he hasn't lost blood. All that's happened is his heart has stopped beating—the definition of "clinical death"—and his brain has shut down to conserve oxygen. But what has actually died? As recently as 1993, when Dr. Sherwin Nuland wrote the best seller "How We Die," the conventional answer was that it was his cells that had died. The patient couldn't be revived because the tissues of his brain and heart had suffered irreversible damage from lack of oxygen. This process was understood to begin after just four or five minutes. If the patient doesn't receive cardiopulmonary resuscitation within that time, and if his heart can't be restarted soon thereafter, he is unlikely to recover. That dogma went unquestioned until researchers actually looked at oxygen-starved heart cells under a microscope. What they saw amazed them, according to Dr. Lance Becker, an authority on emergency medicine at the University of Pennsylvania. "After one hour," he says, "we couldn't see evidence the cells had died. We thought we'd done something wrong." In fact, cells cut off from their blood supply died only hours later. But if the cells are still alive, why can't doctors revive someone who has been dead for an hour? Because once the cells have been without oxygen for more than five minutes, they die when their oxygen supply is resumed. It was that "astounding" discovery, Becker says, that led him to his post as the director of Penn's Center for Resuscitation Science, a newly created research institute operating on one of medicine's newest frontiers: treating the dead. Biologists are still grappling with the implications of this new view of cell death—not passive extinguishment, like a candle flickering out when you cover it with a glass, but an active biochemical event triggered by "reperfusion," the resumption of oxygen supply. The research takes them deep into the machinery of the cell, to the tiny membrane-enclosed structures known as mitochondria where cellular fuel is oxidized to provide energy. Mitochondria control the process known as apoptosis, the programmed death of abnormal cells that is the body's primary defense against cancer. "It looks to us," says Becker, "as if the cellular surveillance mechanism cannot tell the difference between a cancer cell and a cell being reperfused with oxygen. Something throws the switch that makes the cell die." With this realization came another: that standard emergency-room procedure has it exactly backward. When someone collapses on the street of cardiac arrest, if he's lucky he will receive immediate CPR, maintaining circulation until he can be revived in the hospital. But the rest will have gone 10 or 15 minutes or more without a heartbeat by the time they reach the emergency department. And then what happens? "We give them oxygen," Becker says. "We jolt the heart with the paddles, we pump in epinephrine to force it to beat, so it's taking up more oxygen." Blood-starved heart muscle is suddenly flooded with oxygen, precisely the situation that leads to cell death. Instead, Becker says, we should aim to reduce oxygen uptake, slow metabolism and adjust the blood chemistry for gradual and safe reperfusion. Researchers are still working out how best to do this. A study at four hospitals, published last year by the University of California, showed a remarkable rate of success in treating sudden cardiac arrest with an approach that involved, among other things, a "cardioplegic" blood infusion to keep the heart in a state of suspended animation. Patients were put on a heart-lung bypass machine to maintain circulation to the brain until the heart could be safely restarted. The study involved just 34 patients, but 80 percent of them were discharged from the hospital alive. In one study of traditional methods, the figure was about 15 percent. Becker also endorses hypothermia—lowering body temperature from 37 to 33 degrees Celsius—which appears to slow the chemical reactions touched off by reperfusion. He has developed an injectable slurry of salt and ice to cool the blood quickly that he hopes to make part of the standard emergency-response kit. "In an emergency department, you work like mad for half an hour on someone whose heart stopped, and finally someone says, 'I don't think we're going to get this guy back,' and then you just stop," Becker says. The body on the cart is dead, but its trillions of cells are all still alive. Becker wants to resolve that paradox in favor of life. URL: http://www.msnbc.msn.com/id/18368186/site/newsweek?GT1=9951 -------------------------------------------------------------------------------- © 2007 MSNBC.com
  19. Will they cover first responder groups like a vol. fire dept.?
  20. swn919

    AED

    Cardiac Science is the way to go... Pedi pads, Easy use, and the QA ablities are great (ie hooking it up to the computer to see the initial rhythm and time of shocks and changes in rhythm)
  21. Does any first responder group in here carry their own malpratice insurance? Specifically in Texas. If so where can I find info on prices and such
  22. Yeah I started thinking about that last-night. But what if the medical director at your service allows basics to push meds under the supervision of the medic?
  23. I understand that..but why cant a basic work under the same status?
  24. Here is my question. I am sorry if this was already brought up. I am a medic and I would allow a Basic to push a med. that I "ordered" and made completely sure of the 5Rs. But what is the difference if you allow a Medic student to push a med? I mean they are still a basic and it is outside their scope of pratice but we all know that students push meds.
  25. I am doing training this month for first responders at the fire station and i was wondering if anybody knew of any good places online to find first responder teaching scenarios?
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