Leener77

Perineal massage is an excellent way to stretch the vaginal opening allowing the baby's head to come out easier and to avoid tearing.....but that involves inserting the finger/fingers slightly into the vagina, so that's out (for most of us anyway). Episiotomy could be an option but there are times where there will still be tearing even with one.....like in a 4th degree tear. Usually a baby gets stuck or has a hard time coming out for other reasons.......not because of not having an episiotomy......like the head being stuck in the pelvis and shoulder dystocia. So I guess I don't really feel it would be a necessary nor a good idea to do one in the field. Unless others out there with more experience that can suggest differently (considering I've never even delivered a baby in the field....lol)

I absolutely agree that checking for dilation in the field is not necessary and (after thinking about it some more) really shouldn't be done simply because of increasing the risk of infection......especially if the water has broken. Also because pre-hospital births aren't done too often, the chance to 'practice' the skill would be few and far between. Labor is completely different from one person to the next and just because it happend one way for one, doesn't mean it will be that way for the next person.......ya just always have to be on your toes, and expect the unexpected when it comes to labor and child birth........it can be a wild and bumpy ride at times..... And although it's something I think would be cool to learn (maybe in a different setting) I suppose it should be left to the professionals that do this on a daily basis........

We were taught in EMT school that we aren't allowed to insert any fingers (unless the cord is prolapsed, in which case you insert your finges inside to release pressure off the cord from the baby's head) into the woman but to check for crowning. I, unfortunately, have never delivered a baby in the field so I don't have any experience in that area but I personally wouldn't mind checking for dilation. It would be another (although not absolutely necessary) tool to help questimate when delivery might be and how much time (if any) one may have to transport the PT to the hospital. But all the other questions need to be asked as well, as Connie mentioned above, which will also help to make that determination. You certainly can't go on dilation alone because you never know how long it will take to get from where ever they are to complete as it is totally different for each woman. Case in point.......It took at least 8 hrs for me to get from 1-5 cm (with my 3rd pregnancy)......but once I got to 5, I dilated from 5 to 10 in an hour......so like I said, each case is totally different especially if this is not a first time mom. It is a skill that I wouldn't mind learning..........I think the thought of being able to deliver a baby is very exciting and learning anything having to do with that would be great......stricly in my opinion of course......cause I know it's not everyone's cup-a-tea...lol!

First of all, Congrats on getting your EMT-B! Second, the National Registry is NOT hard as long as you know your stuff......I took it and had no problem passing it. Some of the questions are worded strangely I guess, but as long as you don't read to much into them, you'll be fine. If one thinks it's that hard, or doesn't pass it.....maybe they should look into a different job . Third, is the job hard??? Nope, not at all....again, as long as you know your skills and class info, it's not hard at all. Shouldn't be scary either.......it can be a little at first i guess, because you aren't sure of what exactly to expect, but you become more comfortable/confident as you gain experience. Can it be a career?? I suppose if you wanna work like 80+ hr a week and have no life and wanna get burnt out REAL quick. It simply doesn't pay enough to make it a career. I would suggest you further your education and go on to either Medic school, or nursing....as the others suggested. But I also think you should work as an EMT for a while until you can feel comfortable/confident in your skills and be able to determine if this is something you wish to continue doing. Some people change their minds once they get out on the street. I happen to know a couple people that did. I don't know if i'd necessarily say you have peoples' lives in your hand, but the decisions & actions you make as far as Pt care are very important. I'm an EMT-B as well, and enjoy doing it part time. It is not my career. I do plan on going back to school for either Nursing or Medic but haven't decided yet because it's not something i need to decide till my kids are a little older and I have more time to devote to school. I've been an EMT for about 6 years but only on the streets for 2 and there is still so much I haven't seen or experienced especially only doing it part time/per diem. Take it or leave it, but enjoy the learning experiences and use them as a stepping stone onto bigger and better things :wink:

I suppose, but I have been an EMT-B for 6 years now have only been on the street part time for less then 2 years. For a while I was only volunteering about once a week. Then I got a job working once a week (paid) in an area that has a very low call volume as well. So on an average I only work twice a week and that's just in the last 8 months.......but I feel confident that I can make the call as to if I need medics or not.....some are questionable sure....but if I have any doubt, I'll get medics just to be on the safe side. And I'm far from 'medic dependent'. And I do understand that as a new EMT, you need to gain some experience to be able to make those kind of calls. I'm not referring to anyone specifically, but I do personally know people.....that work even more then me & have been EMT's longer then me......that are still clueless and I simply don't understand why. It's BLS.....not rocket science. So basically I'm not disagreeing with you......just giving my point of view. It does have a lot to do with how much experience an EMT has and what grasp they have on BLS care. Does that make sense?

I work in NJ where all ambulances are BLS and ALS are only dispatched for certain calls or if needed. Some ambulance companies are largely volly based. I work for one that is all paid and also for one that is part paid staff, part volley. In my experience I have seen that there are some EMT's that are VERY 'medic dependent', and some that have NO clue if/when to call for medics if they haven't already been dispatched. Or may not know if they need to be recalled. I'm not sure what the problem is.......are these EMT's not being educated properly or do they have no common sense? Or both maybe? I personally am pretty confident as to weather or not I need medics. A PT is either sick or not sick and can be managed by BLS. Or if I have any doubt in my mind or a gut feeling, I won't recall them or call them out if they haven't been dispatched. Some medics get pissy that they actually have to do their job, but most are okay with coming out and at least just check the Pt and if they aren't needed, they'll release to BLS. I have recalled medics many times simply because they were not needed. It's sad we have EMT's that are clueless when it comes to PT care and what kind of care a PT needs but I guess if that's the case, then i'd rather have them get medics and and be told they aren't needed after Pt assessment, then for them NOT to call when they are needed and the Pt suffers because of it........better to be safe then sorry in a case like that I suppose. But if an EMT isn't confident enough in their own skills to make a call like that, they shouldn't be on a truck doing Pt care......period! And you sure can't assume your partner will know, cause they may be as clueless as the next person. .......and that's all I got to say bout that.......