cdcmj

sportygirl::So are you all saying that if as EMT-B's and MEDIC's if we had better schooling and training/practice in more skills that it would make patient care allot better?" Better schooling/training/EDUCATION and continued education/CME has nothing to do with more skills. I never said that. All I mentioned was EDUCATION as it pertains to the scope we as Medic's have now, which as already mentioned, is being stripped away due to incompetency and lack of EDUCATION.

All I have to add is that it is absolutely ridiculous to consider not paying people just because they aren't on calls. If you expect one to be ready to respond, in a uniform, and prepared to do the job, they get paid. My other feeling is that if I can't drink alcohol, then I am at work-hence pay me. When you dictate where and when, and how somebody should act, you are employing them.

All of the "hot-topic" controversial issues in EMS right now come back to one thing, and thats education. Improve education and real CE and most of this stuff will go away. OOH anything can be done if it is approached in a responsible and effective way.

crotchity, though I agree leaving your pt. hypoxic is hurting your pt., the whole hold your breath during intubation attempts bears no weight. It is shown that with proper pre-oxygenation, which unfortunately rarely happens in EMS , a pt. can maintain spo2 in the high 90's for a few minutes if left apneic. This is not to say wait a few minutes between attempts, but nonetheless, it should at least alert us to the positives that come from proper pre-oxygenation prior to ETI (less likelihood of transient hypoxia).

external pressure essentially dislodges the CO off of hemoglobin, which in turn decreases the pt.'s CO levels.

Nursing at a professional level starts at RN, anyway you decide to look at it. And CRNA's and NP's are advanced level practitioner's. Hence a need for paramedic being the baseline (min. associates), and up and away we go.

PR and public programs are secondary. EMS needs to be responsible for EMS. We control our own destiny. Dust, I disagree that we should have 2, 4, or even more levels of provider. All they are are more levels for ceilings of education. A profession does not have 5 levels of provider. Hence, reshaping of how we do things needs to be employed. We do on average 5% real emergencies. The other 95% of the call load needs to be addressed not only for the patient and community sakes, but for the future survival of our industry as well.

Agreed once again Dust. I am actually working on getting aboard an initiative out here in Pittsburgh to propose an out of hospital practitioner professional title, educated to the level of a PA with emphasis on the out of hospital delivery of medical care. This also entails all facets of healthcare, not just the 5% true emergency calls that we all generally deal with.

Dust, glad to see somebody else agrees with the notion that when you fix education, you fix alot of other things as well. HIGH Educational standards= a profession= a lot of the issues being talked about in this thread being resolved as a consequence of the one change.

National Standard Educational Requirements. Federal mandates/leadership to take over, no longer let states pick what they want to do. If we had real requirements, possibly through licensure (more education) and not certification, I would say a large portion of our issues would resolve themselves (from pt. outcomes and skill proficiency to practitioner compensation).

amen crotchity, I never understand the life long EMT-B or career EMT-B, ie one of my partners who has been an EMT for 26 yrs and never attempted ALS education..

As somebody who is in their last semester for an Emergency Medicine BS degree at a four-year university, I can attest first hand that this should now be the new standard for out of hospital practitioner's.

I am glad to some attitudes shift towards a sheep/following someone over the bridge mentality to one of taking responsibility for one's self. The phrases 'usually' and 'for the most part' keep getting flung around when describing LEO's being your savior. For real!!? As emergency workers and public entities, we all should be even more aware of the limitations of our own services. I dont know where anyone else works, but here, theres never a guarantee your armed white horse will arrive right when you need them, and how about the one in a million chance factor...anyways, I could go on, but its atleast healthy as a group to hopefully recognize and be conscience of the real dangers we face as a profession, and the possibilities of leveling the playing field.

precisely, it is a tool in the tool box, one that could potentially save your life, not necessarily your patients

Most people stating that guns/protection have no place in EMS have clearly never worked in some areas of the country. I work in urban areas of pittsburgh and surrounding suburbs. The theory is that EMS should never be anywhere dangerous without police is all good and dandy till you get called for a sick person that turns in to a gun fueled domestic violence. Anyways, at the very least, i think it is ridiculous that I am denied by law to carry pepper spray on the job, whereas my grandma carries it 24/7.....

hahaha to the above comment, don't get me going on the 'slob' medic, who wouldn't pass a physical for entrance in to an old folks home

I believe Polo style shirts with service title/emblem/name accompanied with provider cert. level is what is appropriate. It fits the needs of both provider and employer, ie. professional, clean, and most importantly COMFORTABLE, so I can do my job in the best conditions possible. Also, I see no problem with wearing company t-shirts between the hours of 10pm and 7am. Who cares honestly, as mentioned above, scrubs are not professional but they cater to the job and employee...go figure. This job is like few others, when we are awoken in the middle of the night for an emergency, let us do our job in the most comfort as feasibly possible.

thanks former... but I actually got my start in montgomery co. MD and am already cross trained as a medic/FF already. However, at this point in my life, I am looking for county wide third services, that are 911 primarily, young male friendly, and EMS only. I often have to explain my reasons for not returning to montgomery co. to family and friends, but it boils down to that is a place to settle down with a family, not be single and 22. Thanks! Keep em coming, what is it like down in Lee county FL and austin-travis county TX by the way----two services that I am very interested in .

bumpp..

PS: Lee and Pinellas county EMS do look attracitve, any further info from personal experiences greatly appreciated

AK, that is the type of post/review I'm exactly looking for, I appreciate it---anymore? bump..

Ok, well, Floridians--take a look at my post, do you all know of services that fit my desire's. I have looked in to lee county, miami-dade, monroe, and Pinellas sun star ambulance?? Comments, suggestions, advice, experiences is what Im looking for.

ok how about a county?

Thanks spenac for the response..Got a website? Also any floridians out there!

Hi all, I have been lurking here for a little while and this is my first real post. Background: I am about to turn 22 yo. I was a volunteer FF/EMT since I was 16 and in High school (bethesda, MD). I came to Univ. of Pittsburgh with the idea of pre-med (dads a doc, moms a nurse). Long story short, I found myself in the school's Emergency Medicine BS program. I am going in to my last year of undergrad and this program and am starting to formulate a plan post-college. I am now a NREMT-P working at a city third service (911 only) south of Pittbsurgh and I really do enjoy it there. Diverse people, quality calls, in my opinion just the right amount of 'action', and not to mention two adult level I trauma centers, and one level I PEDS trauma center all within 15 min. of my primary service area. All experiences that I am sure will be of great benefit to me later on in life. Anyways.. I am at a crossroad. I am trying to figure out if I want to stay in school, or hit the work force running, or a combination of the two. And what do I want to study if I stay in school and for what ultimate goal. All things in mind, I also would need to decide if I want to stay in Pittsburgh.. What I am here to ask you all is suggestions, advice, and comments with regard to a person in my situation that is open to really anything at this point. I am looking to explore the states. I have looked and lurked online at services in Florida, Texas, Arizona, NY, etc.. I am looking for a third service type of place that is preferably a county wide system. I want a place that is nice in weather, haa, hence why I have looked places in the Keys, Pinellas county, etc. I am willing to budge on the area, but these type of places entice me. I am not willing to budge on this issue. Regardless of the setup, I want a respectable, 911 contract place that does 90% or more 911 response. My own personal philosophy is that I did not get this education to do mindless transports and I know that I don't have a passion for IFT's Or non-emergent type calls. I am also leaning away from a fire-based EMS. I worked in one as a volly in MD and it was just ok...Also, I dont want the commitement of a fire academy and I am not sure if I want to be a paid fireman. So...In short I am looking for a large coverage area with a good sized population, that would be considered mid-size, ie I am weary and leaning away from burn out heaven places such as NYFD, LA, Miami, etc. One of the things that I like about my current service in Pittsburgh is the fact that we do no BS transports and have just the right amount of quality calls in a shift that you don't get burnt out and don't get bored, all awhile seeing a whole gamet of things. I appreciate all comments and suggestions, and I am glad that I finally posted on here and look forward to other Medic's who I am sure have travelled the states and have wise opinions of certain services, cities, counties, states, regions, etc. Thanks! Edit: PS, I forgot to mention that the place needs to be friendly to a most likely single-no string attached-young male. Also, any suggestions to the area's I mentioned in FL, Arizona, Texas etc would also be welcome.