ccmedoc

A Howland lock is attached between the handle and the blade to provide a mechanical lift advantage and better angle to visualize the vocal cords. Never used one, but I have seen it used. Looks kind of awkward to me..

I got a chuckle out of this one also...It is the material, or lack thereof, not the instructor boring these students. Most likely, anyway...

This will most likely change in the future..sooner than you may think. Especially in the fire service where the competition is much greater, due to the '2 or 3 out of 60' you identified. More and more fire departments are requiring degrees to even get an interview. If a paramedic license is required now, a degreed paramedic will be required shortly..simply due to supply in demand. It is a weeding process more than anything. Have you not noticed that, even in the fire service, degrees in almost anything put you in the front of the line for interviewing process. They may not be ALS service, but still require paramedic license and a degree, at least an Associates. I am not a firefighter, never have been, never want to be, but I can see this. 'Times they are a changin', and to suggest that preference be given to a non degreed program over a degreed program is ridiculous. The graduates from Community Colleges that I have precepted and worked with are far more advanced than the graduates of private service classes. If for nothing else than the additional language arts, mathmematics, A&P, Patho/Phys, and pharmacology classes required by these institutions. I have worked with and around graduates from KCC and LCC, and have been pleasantly surprised. I have had the opportunity of knowing the instructors and administrators of the EMS program at KCC, and I don't believe they are overrated. If a graduate fails the boards after a KCC program, it is their own fault. Again...My opinion, but I do have first hand knowledge of both programs. If the distance is not too great, I recommend either one. Take it for what it is worth...

That would limit you to either KCC (kellog community college) or LCC (lansing ...)..I am not up on the basic classes in the area, but I know these two have additional paramedic and nursing programs and are a fairly well respected..I would stay away from the fire stations, hospitals, and ems agency programs. They may be good for you distance wise, but you get no credit or degree.. I have not seen a non-college based program worth a s**t in a great while..They seem to cater to fire or their own agendas, especially the private ems agency programs.. Take it for what it is worth..

Oral could be taken to mean transmucosal as well as enteral...anything in the mouth "implies" oral..not necessarily swallowing. That would be enteral..involving the esophagus, stomach, small and large intestine...you get the point.. :wink: ..nuff said :oops:

CONTENT REMOVED - ADMIN I can't understand why they would want to carry a pressurized (read dangerous) cannister of oxygen around with them in their POV..CONTENT REMOVED - ADMIN Besides the prescription drug issue...

I would say most of the discussion previous was about saline locks vs. running drip KVO. Lines in the critical care arena are vastly different, as you pointed out. I have a fairly open mind, besides being anal retentive (or arse hole) at times. I usually will have heparin in thePICC or CVC if it is not running or monitoring, and an A-line is usually monitoring, so no need. I still flush the A-lines periodically with saline, as you know..Kinda goes without saying.. This was never meant as a challenge to you, as you no doubt have more latitude than most ANY EMS in the states. Only a point to the US medics on not having to necessitate an infusion line over a saline lock. To be sure the way you and I conduct business is probably a bit different.. Sorry about rehashing the cookbook stuff..sticks in my craw sometimes.. Ok..what is MTC.....I have an idea, most probably wrong.

I can give you a rough estimate....

WooooHooooo :toothy7: :toothy8: :toothy7: :toothy8:

Oh, I thought it may be the sister Dust referenced....my bad :oops:

Who's Marianne?? :?

I have not seen a properly flushed saline lock clot in the 10-30 minutes it takes to get to the hospital. I think it would be a great idea to put a lock in, flush it for patency, then if you need a line hook it up. It is quite evident when you flush it with 5-10cc of fluid if it is patent or not. I can't see any med control worth their salt complaining about a saline lock when they would let a medic infuse a bolus of NS without an order.. I don't like to believe that their are individuals out there that blindly follow "cookbook" orders for interventions, as I have not seen many "textbook" presentations that meet a narrow criteria for treatment..most protocols are general at best (as they should be) and this requires a bit of independent thought and willingness to act. What do you do if the patient presentation is not in the list of possibilities given to you or your "cookbook"?? Note: sorry for the spelling corrections..I was feeling a bit retentive 8)

There you go..question answered.....next?

:thumbright: :thumbleft: :cya: edit: I thought it was spelled with a K. Looks better that way..

She is one Bad MF'er, in my book :thumbright: . Freakin' Texans

Yeah , Kinda depends on the qualifications..I don't see a lot of those letters as "qualifications"..busy work, maybe.. But, it often doesn't matter what I think..

previously, and often, we have established that a few EMS professionals have suspect assessment abilities..But I agree with your point.. Big brother.........Oh Brother! :glasses5: :glasses4: Good 'ole American paranoia..

Yes..very bad move :roll:

If your asking about allergies on DL..maybe a bit extensive for some, maybe peanuts or beestings would be nice. Gives you a head start for unresponsive pts. I think the noting of diabetic would be nice, for the reason you stated. I think the ICE thing is a joke..personally :wink: HIPAA (*notice the letters used ) doesn't really apply with this. *Health Insurance Portability and accountability Act

DwayneEMTB..Very solid post. You were VERY lenient with that 1%..I like this statement though A very strong position argument throughout..well put!

EMS= Extra marital sex...doesn't it?? :roll:

You know, of all the comments made in this discussion, most of them valid, this one sticks out in my mind for some reason. I have a question and, given the topic, I think it has legitimacy.. Do we know the difference between infectious and contagious and do we know where the diseases we are talking about would be classified? Just some food for thought... "...all contagious diseases are also infectious, but it does not follow that all infectious diseases are contagious" -- W. A. Hagan

As have I. Paddles arc and, when the uber-excited medic forgets the gel or saline pads...EWWW, that smell :shock: The pads are quick, easy, and..well..quick and easy. I like that you can pace with them too..You need to make sure of good contact and lots of chest hair makes for a fun show sometimes.. I don't like the paddles anymore, although a lot of EDs still use them with the lifepacks and HPs and such..

Maybe if its in the context of sayyyy.....Sleeper holds, joint locks, and pressure points..Yeah, I can see it..

See, the thing is...we are supposed to be health care professionals and, as such, we are supposed to have additional knowledge through education on these topics. We are supposed to know, for example; how the diseases are transmitted, the latency of certain viruses (approximate), and the proper way to protect ourselves and the patient from infection, to name a few. Like it or not, the public expects this. Given this knowledge it is expected that the professional, acting as a professional, should know to take every precaution to limit the chance of infecting themselves or the patient. Often times, this is not entirely possible. To say that a health care worker should not work every time they have a sniffle is asinine. But these same people pose a very real threat to immunocompromised individuals whether they be cancer patients, HIV patients, or simply elderly. We need to know how diseases are transmitted, with reasonable certainty, and how to minimize the risk of transmission. The risk is acceptable when the HCW has taken the appropriate precautions, based on evidence based research, that minimize the chance of transmission to the lowest possible degree. As I mentioned earlier, to a growing demographic..the elderly.. a seemingly simple cold or 'sniffle' and pose a potential deadly threat. Should you be held accountable for transmitting this illness and the ensuing long hospitalization and death??... We are supposed to know the dangers, and the limits to which we can function effectively while minimizing said dangers. A risk is considered unacceptable when all rationale and knowledge of the disease process and probability of transmission are ignored. I would say that crawling around an MVC with blood and body fluids present, without the proper protection (i.e. Leather gloves, turnouts or other protective clothing, helmet with mask, etc.) would pose an unacceptable risk to the HCW and patient alike, healthy or unhealthy. I would suppose a better question to ask is how do you determine when a HCW is too high of an infection risk? The HIV , TB, and Hep B that has been cited in numerous posts can certainly kill, and may be dormant in the body for years before presenting with symptoms. Far from a death sentence. The same HCW with a sniffle or chest congestion can pass a seemingly harmless bacteria or virus to an elderly or otherwise compromised patient, and death can follow in a matter of weeks....Who is the 'acceptable risk'? Is is realistic to say that these HCWs should stay home until the sniffle is gone? One last thing..it was brought up about universal precautions not being a guarantee from infection. I would say that these precautions do, in fact, minimize the chance of infection to the lowest possible factor. The precautions are, in fact, guidelines to follow and not the equipment proper. To ignore common sense and put the HCW and patient at unnecessary risk, as extrication without the proper equipment, is negligence...IMHO.