mstovall

The sirens also do a good job of scaring away deer. You just have to watch out for the suicidal ones. The ones that go straight away from you and then turn 90 degrees into the side of your truck.

Our Union class on 12 leads is taught by a cardiologist and is 24 hrs long with a 1 on 1 test session with him. I don't know of many institutions that dictate this proficiency. We have multiple classes to accomadate the multiple shifts and part-time scheldule. Short of pushing for everyone to become a cardiac tech, I don't see what else we can do. Oh did I mention that this is a PAID FOR CLASS. I have never had this opportunity from our state associations. I do believe that associations have their place, it is just not to represent me and train me. They are there to be a lobbying group, which they do not have the connections of the unions that have been around for 100 years or so. heck, EMS isn't that old. I seems to me that many who are bashing unions don't truly know what they are there for, nor have they been a part of an effective Union. If the Unions that you have been affiliated with have not met these minimum opportunities, you whould have voted out the leadership or moved to decertify the union, but you do have to be involve to force them to work for the betterment of the work place and employees. Remember that Unions were formed to Increase wages to a sustainable living wage, improve safety of the employees, and improve the education of the employees. What is so wrong with that? If they are not meeting these three goals, you don't have an effective Union. And a collective voice is always louder than an individual who tells of a company's short-comings on an individual level. If they didn't, why do we need associations for? Michael

I work for a Union shop. I am also a union officer. We are represented by the Boilermakers local P-3. This being fully disclosed, I will say things that I have said internally as well as privately to employees at my service. First, in the USA, regardless of if it is a closed shop or not, people have the right to sign a Beck letter on the grounds of religious or political beliefs that prevent you from paying you dues. You are still responsible for paying the percentage of your dues that goes to internal expenses that affect contract negotiations, labor/management meetings, and leadership training that supports these two parts (i.e. steward training classes, contract negotiation contracts, etc.). The part a Beck objector has to pay in usually can go up to 80% of the normal dues, but not exceed that percentage. The Beck objector also gives up their right to participate in Union activities (i.e. CE), Union elections, or Union events (i.e. labor picnics). Second, as a public employee also, although the local association has no striking rights, the local government has to bargain in good faith on contracts, or they are subjectable to forced binding arbitration. This may keep people from striking, but it requires that governments act in a fair and equitable manner. The problem with unions in EMS is that there is not one Union nationwide that represents us. The FF have the IAFF, the auto industry has UAW, coal miners have UMWA, utility companies have IUWA, etc. The EMS community has IAFF, Boilermakers, Steelworkers, and many others. To develop a voice on the national front, we need a nationwide single voice for us. Instead of slitting each others throats, we need to stand together. The Labor movement in the US has only been effective when employees unite with a common voice. That is how in the past they received better wages, better training, and a safer work environment. No occupation has ever improved their lot in life in the US without a voice of Labor except politicians. Heck even doctors have the AMA. As for representing the trash of the employment and not letting them get fired. I have stood up for people many times that I disagreed with their action. However, everyone is entitled to due process. If our contract outlines how they have to go about firing someone, then the company needs to follow that. If we allow them to selectably fire and hire differently for each instance, then the same practices can be used against respectable people if they are not in management's favor. As for management and labor relations, we have great relationships with lower and middle management. As for higher level managers, they refuse to come to the meetings and they are not held in the same light as others. I will agree that most unions representing us lack the power that the bigger unions have, but that is because we as and industry have failed to unite together under one organization, an organization that wants to represent us. If the NAEMT's chooses to step up their efforts to unite the industry under one voice, I would be all for that. I would probably push for reaffiliation to be part of a movement like this. Until they choose to represent the individual on the front lines on a personal level, they will not be able to have the voice of the industry. The UAW have changed many things in the auto industry, from saving jobs, to higher wages, to better benefits, they have done a great job of representing the workers of their industry. Until we have a common voice that will look out for us in the local environment, we will never have the unity to change a nationwide persona of what EMS should be like (wages, benefits, training, etc.). As much as the IAFF has been talked down upon on this thread, look what they have done for FF's across the US. Don't we deserve the same benefits? I don't think the boilermakers are the ones that will pull this industry together. The NAEMT is the only organization for this movement to take off that I see. Unity brings more change than education on a personal level. Unity has a bigger voice than each of us writing separately to our congressman. Unity is the only means of moving our industry to the levels that many have expressed reaching (better pay, better benefits, etc.). JMHO, Michael

This is the way I was taught and I think that the teacher did a great job of blending the theory of the skill sheets with practical knowledge. The teacher first started each class going over the skill sheets. We did this for a couple of weeks. Then the teacher would through things in. I will never forget killing my patient. I gave my nitro for the chest pain prior to examining his chest. When he opened his shirt, viola, a moulaged chest wound from a fight the night before in a bar, representing an alleged cardiac tamponade. Next week someone gave him AS for a CAP and then found out he was allergic to aspirin. He did a good job of doing different things, going unconscious when you didn't get a SAMPLE on a medical, multiple symptoms, etc. He always built upon what was being taught that night. This made you want to read more, apply what you knew so you weren't the one who killed him that night, and the routine drove home how to pass the practical test. The scenarios he used were from runs out of our local service. Hope this is the type of answer you were looking for. Michael

That's nothing. I had to have my prostate examined the other day. I'm still wondering how he did it with both hands on my hips. :oops:

I am sorry to hear about your losses. I got my start in EMS in Carter Co. Several people I knew where in Washington Co. That whole group is a very deligent group. Michael

We require that a person be ANO x 4 (person, Place, time, and events leading up to us being called). If we don't have a good feeling about something due to ETOH or drug related, and certain BH's, LE is informed and we stay on scene until we get their blessing to leave (this is done as a witness to the refusal form). Michael

After reading this, hearing this subject conversed about in class and in the station, talking to partners, examining ink on patients and employees, and much introspection, I have come to the following conclusion. It is not the ink that bothers the patient, it is the general appearance of the medic/emt that makes the impression. Is your shirt tail tucked in, shirt pressed, do you look clean, etc, is how we are judged. We are also judged on how we look as an entity. Are we uniformed and look professional or do we look like a bunch of rag tag individuals thrown in together at a moments notice? I think services where they are all in the same uniform and the uniforms are worn identically, people tend to think higher of this group. I think they have higher esteem for these individuals whether they have tatoos showing or not. On the other hand, there are individuals that have a nice appearance that make bad impressions from there body language. We speak with so much that it is hard for me to think of one part of an individual that I seem to make a judgement call about. When we look at a patient we look at their surroundings, dress, appearance, and so much more to get that first impression. What does a patient think about if your truck is untidy inside, your shirt tail is hanging out, and you have a prison style tatoo? What do they think if a person is dressed out in B's, polished shoes, truck nice, neat and orderly, and the person has an empathetic approach? We need to patrol our activities and mannerisms more than our body art. We need to look professional, not like a rag-tag bunch of individuals that just through some wrinklely clothes on. Until we do this, tatoo or no tatoo, we will look like we are a group of just unorganized individuals. JMHO, Michael

Some scenarios that I have seen are Car versus pedestrian multiple broken bones, limited LOC; pregnant lady in car wreck remember to position the patient a little on their left; fall from a roof with ETOH involvement; car wreck with two individuals, one deceased and one with bilateral femur fractures. Not many drugs except O2, but the most is how you handle the trauma (control bleeding, immobilize, etc.). Be sure to have the c-spine protected before you talk to your patient as this is an automatic fail criteria. Be sure to go over your books thoroughly as the class moves at a very rapid pace and caps on what is in the book. Hope this helps. Michael

HUA-pronounced "who-uh" Head Up Ass PIE-Phone In Ear DAS-Drunk As Shhhhhugar all referring to causes of accidents.

I use PePid. Here is there web site. It is excellent for drug calcs as all you need is the drug, age and their weight. Also has helpful things to go along. Several free trials on their site so you can see if you like before you buy. here is the site http://www.pepid.com/. Can't seem to get it to direct link. Maybe admin can fix it to link. Sorry I am missing something to do this. I like this and sevral of the medics love it. Also several of our ED docs have switched to it. The best thing is if you dock or get online regularly, you can set it up to have automatic downloads. I love this because I always forget to do this. Hope this helps. Michael

Never ever ever ever say as you take the first bite of a meal "this person better be dieing." You will work a code. It will be a futile effort, but it will be close enough that you can't call it and feel good about it. I have had three different partners say something dumb like this and it has happened all three times. It usually happens after a day of interrupted meals for stub toes and cough that has been going on for a week, or infected hangnail, etc. Also never buy a movie/rent a movie while on shift. You will never be able to finish it. Instead bring in something that you have watched 1000's of times and you don't care about stopping it anywhere. Michael

My parents switched me around several times, trying to keep me away from my scummy friends. The only problem is that I could find as bad if not worse everywhere I went. Moving a child just to get him away from bad influences is only good if the child wants to change. As for the grandparents, they will also only influence those that want a change. The thing that changed me was some disorderly conduct charges filed by my parents. As much of a badass that I was, I didn't want to go to juvy anymore than I had already been. Just trying to show you a different view point. From some of your comments, I would suggest talking with your pastor. He may be able to guide you in local alternatives better than any of us. Michael

Just out of curiosity, which county was it? Michael

A friend of mine flew for AirEvac for a while. He said he was making between $800-$900/week. Another friend of mine is working for PHI and is making between $1300-$1700/week, but he is also a PAC. I think he is equivalent to a manager/supervisor. I have not seen their checks, but this is what they report to be true. Others may way in on actual earnings. Michael

As someone with a BS in Biology and BA, minor in chemistry, physics, over 200 hours of undergrad and 30+ of grad, I can say that I don't see a true need for a 2 year program, aka associates, to practice as a medic. Selective hiring eliminates those who cannot write legible and intelligible run reports. I know of individuals that have PhD's that cannot write a coherent e-mail, let alone think they would ever be able to learn to write a good narrative. Mathematics come easier to certain individuals than others. If drug calculations are that important for you to do in your head, we need to eliminate many of our highly trained physicians. Many of these docs rely on PDR's and many of the new programs to do their drug calcs for them. What we can do is follow the p's of proper marketing. Promote ourselves, properly place our services for ease of use, price the services in a manner to pay employees a living wage, package ourselves (make ourselves readily visible, no t-shirts, no jeans, wear uniforms that reflect professional attire). If education was the key, then hospital and fire based services would pay accordingly. They would not have a disproportionate pay rate. It is not the education that allows them to be paid more. It is the placement and promotion of service that allows them to draw the higher check.

I think everyone is missing the point. The problem with low pay in EMS is not education, union representation, certification, or other addressable problems. It boils down to one thing, cash flow. The cash flow that is generated by EMS resides many times on entities that under pay for the service. Medicare, medicaid, and self pays (which are the three biggest parts of our run volumes) pay the full bill at a much lower rate than insurance companies. The ambulance then has little recourse as it is infinitely hard to get the individual to pay the remainder as most don't have the money in the first place. Hospital based services around my area pay better, they make their money on the admission rate after the service takes them to the hospital. fire base services have their runs supplemented by tax dollars. It is hard for a service to pay higher wages with a low rate of return. So how does EMS move forward. We have to find ways to get paid more. My service doesn't charge for responding to MVA's. I was looking at my insurance policy the other day though and they will pay $250 to fire, $250 to ambulance, and $100 to wrecker service. I called worried about the low level of pay to the ambulance service and the reason for a low set rate was, "this is only if you refuse treatment. Many places are starting to charge for showing up on scene for taking an ambulance out of service." Our service handled 6 wrecks in the last 36 hours. The volunteers lost money that could start paying paid-on-call people. We as an ambulance service didn't get the info to even pay for the response if they wanted to charge. We need to expect payment for our services. We are not just a fly-by-night group. If we do not expect to gain the info needed to charge individuals, then we can't complain about low pay. We need to help increase cash flow. Higher education is just one venue of increasing cash flow. However, education doesn't dictate more money. Look at the psychological field. Most places require a masters to work in addition to state certs. Look at social workers. Masters degrees and state certs don't help them either. Both have low income sources with limited funding thus they have low rates of pay also. Look at stock brokers. No education requirements, just licensing and a few endorsements and you can make a lot. They also aren't afraid to charge for what they give you, service. Education is a good starting place, but better cash-flow-in is where we need to work on. The companies will be more likely to pay us more if we can prove they will make more in return. JMHO, Michael

The flip side of using air in rural areas is that it keeps the ground guys at base. If they transport from some of our outlying areas to a trauma center, that truck is out of service for 3-4 hours. In small communities not only does it speed the transport to the trauma center on the critical cases, it keeps the limited resources where they are needed. As in Jakes reference from the outlying hospitals, if a ground crew took the transport, how long would that district be down in resources? The lives they save may not always be the one that is flown, it may be the one that is a simple diabetic that would not have ALS care just after the flight crew left.

I am surprised that none mentioned AMLS. It would look like that would be a better course for a Basic then anything. I haven't gotten to go yet, but I plan on going. ITLS (formerly BTLS) is also a good course for basics and they have two levels in it as well. One guy in my class has taken both the PHTLS and ITLS and said that for the advanced level, ITLS was harder to achieve. I guess it would truly depend on the instructor. AMLS schedules can be seen on the NAEMT website also. Michael

One other thing to remember is that OSHA regs are the MINIMAL that a employer has to do. They may choose to make it more stringent if they choose. The same with NFPA. Michael

I think this will vary from area to area. Heck in my own county there are some districts who have a better volunteer than paid crew, while others have a more passionate paid crew. The volunteers here get more training that the paid crews, and that is a shame. In most fire districts, you get several vols to help. They range in skill level from first responder to paramedic. Many are also paid professionals and vol. in the county (rural) where the paid crew may be 15-20 mins away. The vols average response time is in route < 2 mins and on scene < 5 mins. The first paid will get on scene with an average of 7-8 min response time. Now if the same guys are vol. on their days off, are they more passionate then than when they are paid? I don't think so. They just care about their neighbor enough not to sit around when they are in need. They respond with equal skill whether they are on the clock or not. I love it when I can beat the paid crews and vols in response time, but that happens very little. As for a patient, I would feel better knowing someone is there. I also like the feed back from the scene so I know what to take in. Heck, many-a-time they have the patient packaged, lines started, airways in, monitor on and we can just load and go. I think that passion is not the question one should ask, it is who delivers the life saving skills needed the quickest. Again this will depend on the area you live in. My biggest question is what are we to think of the counties that are too poor to have a FT crew (fire or medical). One county near me has paid-on-call, but this is a greatly reduced fee (I think it comes out to be about $2/hr), unless they are making a run. It is hard to make an assumption that would be correct for the whole country, let alone many states. JMHO, Michael

Ok I have spent part of the day looking over the OSHA regs. All I can find is that facial hair is a contributing factor to poor fit, but no statements that require you to have a clean shaven face. It does say that the employers are suppose to use a quantitative fit test (the one that actually measures the amount of are circulated and "leaked in and out" of the respirator. It even states in one of their reports that the growth of facial hair is grounds for a retest within a two week window if the employee feels that the seal is compromised. Here is a link to the explanation of the new rules on OSHA's website http://www.osha.gov/pls/oshaweb/owadisp.sh...&p_id=13749 (sorry it does not supply a direct link, but I couldn't get it to work like I thought it should on this forum, admin feel free to fix this link and delete this parenthesed text). Hope you enjoy reading, but it was very informative for me. Michael

I still don't know what to be more outraged at though. I sit and wonder if they were this way because of his situation and just wanted us to make him go away or did they not really see something wrong that they could do something about. I mean, at a methadone clinic you probably see many things, but we do to. I might be tired of hauling someone in dozens of times a month, but I still haul them in and take care of any needs they might have. If they are going to do these things they need to be in a different setting. Still frustrated and am not happy to see others are experiencing the same thing, but do appreciate the comments. Michael