Just Plain Ruff

Forgive me but letting an emt do triage is similar to letting a 5 year old change your Electric breaker box. Sorry if this offends the emt's out there but really, you think that you can triage someone with 110 hours of emt class. That is absurd. I am more comfortable letting a paramedic do triage(not because that was my favorite parts of the job at the ER I worked at and I did the triage) because at least in medic school you learn additional medical stuff (I know bad wording but the right words did not come to me during the typeing) An RN is the absolute logical choice but paramedics could do in a pinch but triage to me is not the same as triage in the EMS world. Triage in the EMS world is triaging more than one patient into priority to be treated and transported and how many units and helicopters you need. The minimum for triage in the ER should be a paramedic but ideally an RN is best. You also have to look at the hospital by-laws and see what exactly the EMT can do. Most hospitals that I know of and I've seen all the ER's in the KC area, most of all the ER's in the mid-missouri area and not one has EMT's as their triage nurses. I've worked with ER's to computerize them all over the country from Colorado (level 1 trauma center), New York City (level 1 trauma center), Detroit Michigan, Dubuque Iowa, Sioux city Iowa, Baltimore maryland(shock trauma and Mt. Sinai), Olathe kansas, Springfield Mass, Mayo Clinic In Jacksonville, St. Vincent's in jacksonville, St lukes in Jacksonville, St. Josephs, Patterson NJ, Jackson Health System, miami Florida, Butler MO, Nevada Mo and many others. All those listed do not have emt's at triage. Maybe EMT's at triage for vitals and the like but never doing the triaging. All these above hospitals cannot be wrong. Sorry, not

Actually "Miss Voice of Reason at EMTCITY"(I say that with complete respect for you Wendy) this movie is a comentary about current times rather than future. Obesity - current epidemic Garbage - current major problem no face to face time - I know this is an issue as I'm sitting in a training room right now emailing my colleague who is sitting in the next row up and we are the only two people in the room. Additional non face to face - I was in a small class and I was texting one person in class and that person was sitting right next to me Social commentary - yes, applicable to current circumstances in the world today? ABSOLUTELY

Sorry they charged this yahoo Dodds because he had the money to pay the charge, nothing more nothing less. but you get someone on medicaid and just how do you think they are going to pay the fine? Put em in jail for it then? So who will take care of their children? This is the quandary we are in, do we prosecute and fine all these abusers and never see a dime or do we bill medicaid and medicare and get a little bit of money. And why are WE collectively complaining about these abusers? Sure we can sugarcoat it and say "It's because of these people who tie up ambulances for the real emergencies which is the real cause of the problem" this I don't agree with. Personally, when I was a new emt and even newer medic I gritched and moaned about the frequent fliers because invariably when I was running hot to Gracie's house for the hundredth time a cardiac arrest or long fall or head on collision always came in while I was running the call to Gracies house and it pissed me off. I was told by a veteran - shut up, quit yer bitchin and be patient, the next code can and will be yours. I think that for many of us who bitch about the frequent fliers we are really bitching about the fact that "I missed out on that cool call" or I got pulled away from my dinner and I'm pissed.

yes, what I was referring to is the paramedic who now signs his name as ruffems, CCEMT-P but up until their weekend journey into critical care paramedic program they signed their name as Ruffems, emt-p or ruffems, nremt-p

the ability on my command to teleport items. for example, teleport the obviously faking drug seeker to Spenacs Jurisdiction or.... The 100 inch flat screen TV that Circuit city has on display. Zap, it's at my house the 5000 laptop that is on display at Microcenter - Zap it's at my house. Catherine Bell in a g-string - Zap she's at my house fixing me mai tais and doing a sexy dance. Ok question from me who's hotter Terri or spenac

It's amazing what you learn here. Thanks Vent So what do you think would happen to EMS if he went the route that Vent just showed us. What would the ramifications be to our profession if we were as structured as RT seems to be with all the requirements?

Other than infection why do you say that an IV thru the burned area is not acceptable. Is that a blanket hard and fast statement or are you saying that if you have any other place pick that other place. I agree with the IV in any other place than a burned area but the patient I had had 2nd degree on nearly all her body and 3rd degree on a lot of other places. Each place I looked for an iv site was burned. neck, chest, arms, legs etc. This lady died eventually of DIC and numerous other things. But if your rule is never put an iv in a burned area then what would you have suggested. our transport time on this lady was 35 minutes. She was conscious and able to talk to me prior to my intubating her but where do you suggest I start the iv if every place I looked either had 2nd degree or 3rd. degree????? Tell me.

Now Ruffems: Quote: " down to the lowly emt/resp therapist" mean that I thought resp therapists were lowly? good lord no. probably bad choice of words. You just had to focus on that one part huh? didn'tcha, huh, say no more know what i mean nudge nudge. Vent let me ask you this. What levels of cert or licensure do resp therapists have? Is Resp therapist the basic like EMT and are there more levels of expertise out there? I know that some resp therapists that I've worked with just like emt's and medics I've worked who are not worth their weight in secretions suctioned from a ET tube. Are there levels of cert that resp therapists have?

Ok, but let's take it one step further. Let's say a paramedic takes the ccemt-p course(ccemtp) and they have on their name tags - CCEMT-P after their names. Now they begin to document on the reports and sign their name with CCEMT-P after it. What are the legal ramifications of doing so? Does our EGO(see bledsoe's article) make us more apt to do this because it makes us feel good or is it our own vanity that now that I have taken this CCEMT-P course that makes us more likely to put those initials behind our name even to the point of putting it on official patient care records? How would the courts and plaintiff's attorneys take this and run with it. I can only imagine though.

quote="medicv83"]Man Vent, you sure do think nurses are the end all be all in medicine dont you? Im anxious to see your answer to the question. You seem to think that everyone else in here has to do their research, and that everyone else in here is wrong, and that you are just top of the heap. I can imagine what type of physician you must be. Type that has his little entourage of nurses saying "yes sir, yes sir, yes sir" to everything. All your little statistics and what not, they really dont mean a thing to anyone, especially when your posed with a solid question based on sole experience. Your right, the ancillary courses that healthcare providers take are just that....Ancillary, however we are all on the same page generally as far as what goes into those ancillary courses. We all (nurses, medics.....) have had to gain information in order to take those courses and have them be easy. I just think you have a thing for nurses as far as their skill and expertise, because you sincerely cannot stop talking about how great they are.

THANK YOU to Dougd for providing me with enough caps along with my own to get my son what he wanted, no it was not a harrier jet nor a lifetime supply of toothpaste. He wants a digital picture key chain. It's a key chain that has a digital 1.2inch screen. He wants to put mommy, daddy, our dog brandy, our two cats Nalla and Suede, Our water turtle Loppy and his Cichlid fish Rainbow on the device. He also wants to put all the family on it so he can go back and look at them whenever he wants to. Thanks again DougD

so in other words these two paramedics were using the ccemt-p out of context and when asked what their level of certification was and their reply was Critical Care Paramedic was WRONG!!!!!!!!!!!!

Now theres a thought, pull in the most green resident and have them do it.

I was doing some work over in the ER yesterday, getting ready for our computer system go-live and I noticed two paramedics talking to each other. Each of them had on their name badges, CCEMT-P after their names. I asked them what CCEMT-P meant and I was surprised to hear them say "Critical Care Paramedic". I asked if that was a certification or licensure level in Mass and they said Yes "we are critical care paramedics" Not sure if this is true or not but I didn't think massachussetts had that level of certification. I'm going to keep the services names and the names of the individuals out of it. I'm just curious if this is a recognized licensure level? or if it is someone saying to the public that I'm a Critical Care paramedic when in reality I'm really a Paramedic. Could this be against the rules of the Mass dept of EMS or whatever licensing body is in Mass?

yes, it does predict the future, plus we will all be living in one huge ship because due to global warming we had to move because we didn't want to get the fever the earth had.

but you didn't answer his question. 18 year veteran paramedic wiht a broad base of experience doing triage or a 1 year out RN who took ACLS 6 months ago to get into the ER. If it was the paramedic doing your triage would you leave or demand that the RN do it?

I wonder how much it will cost to replace these matts? Will it cost more money to replace the matts or will it cost more to fight the lawsuit and pay out the damages? Anyone want to take a guess.

ok, I missed something Who was ryan hummert?

let me ask something regarding burns. I had a patient one day with nearly 80% burns on her body. There was no place on her body that was not either cooked or crispy. (the difference between original recipe and extra crispy if you get what I mean) I put two large bore IV's thru the burns. I know that you get what you can but what is the current conventional wisdom in doing this, putting IV's thru burns? The nurse was a little upset at the ER that I put ivs thru the burned skin but it was all I had. Any comments?

first rule in burns, put the patient out and stop the burning process. Sounds like someone(not you Firedoc of course) didn't get the memo.

i'll try to find what you are looking for but..... caveat ...... Palm software is not as easy to use for EMS. You might find that it's easier to keep the flip books. That's been my experience. But I will look for something like that for you.

So did you.

Spam I'd take work with a continual pms'ng(female) or Aggressive(male) boss or work with a boss(same gender) who can't keep her/his hands off your butt and other areas(no sexual harassment laws are in effect) so you have no recourse.

Never said these questions would be easy. You have to answer it to keep going. I would choose the lesser victims, less people hurt and affected. But either choice is a bad choice but you have to answer to get to ask the next question.

Pediatrician Question: 1. Serial Killer <12 victims or. 2. mass murderer >500 victims You gotta answer it.