firedoc5

One of the first things emphasized is that when someone is hooked up to an EKG is that you treat the patient, not the monitor. Monitor shows V-fib but the guy is looking at you and joking, you're not going to d-fib him. I've seen it tried. :roll: This can be carried over to other signs and symptoms.

I've always stressed that Common Sense is your best route. Start with common sense and go on from there. Of course there is always someone in a class you are teaching that shows no common sense what-so-ever. But they usually come around.

Good luck, have fun.

Sounds like a good format.

I had seen it a long time ago. Can't remember exactly where. I always gave the comparison of one minute you are at the house of a 98 yr. old woman taking her last few shallow breaths while holding her Bible. The next you are fighting tooth and nail on a 19 yr. old kid that just flew out of a third story building onto the street, freaked out on bad cut coke.

I stand corrected. Balance is a better word than mesh, but I was trying to say the same thing. And what I was meaning about "throwing the books away" I wasn't referring throwing the book information away. Sorry for the confusion.

Vent away. Most of us have been there. If there's more that you want to discuss feel free to PM someone.

One thing I noticed is that many tend to make the math more difficult than it really is. Perhaps from thinking "too much". Or even feel over-whelmed or intimidated about it. Start out with just a couple of basically easy problems so that they aren't blown away by being stumped by the very first problems. If they are stumped at the very beginning they may freeze on the rest.

That's why I would rather have the greenest paramedic in the world instead of the most experienced EMT-B. -------------------------------------------------------------------------------------------------------------------- You should want the greenest paramedic over the EMT-B. If an EMT-B has many years of experience and they are still an EMT-B, then that should tell you something. Either they don't have the initiative to advance or they just can't cut it. It's the experienced EMT-B that becomes the green paramedic that you want. It's all relative.

I've always asked that myself. Also, taking RN's out to become MICN's, sort of like you having to train them so they can give orders to you. :roll:

Maybe I'm just too "old school" or just too old. It's not the age but the mileage. Yes, four years experience in the field and classroom is very beneficial, but not necessarily mandatory. Some may say it's "paying your dues". But if you're playing with yourself instead of paying attention, learning (which you never stop learning), and getting experience in diverse situations, that's your business. Would you prefer someone having run 5 "codes" or someone who has the experience of 50 or more? One thing which has always seemed somewhat lacking is just good ole fashion common sense, like getting into a fight with a Hell's Angels member. A good accurate trauma assessment in the field is crucial. You don't just "load and go" or just give a quick look, thinking that surely someone down the line will just pick up what you missed or didn't bother to check. You may need to bring the condition of a patient to the attention of that someone down the line so they can be further assessed more quickly. And the assessment should be repeated, over and over. ER staff expect a full patient assessment, whether it be trauma or medical. And any change in the patient's condition from the very first assessment (yours) to the next can help immensely. The "beloved" trauma assessment from doctors, nurses, etc. with all the bells and whistles, AND your's together is a true assessment. I'm not here to argue, cuss & discuss, and get into any p!ssing contests. And we could go round and round and round. Everybody can say what they think and go on.

The "attempted suicides" repeaters. The guy who calls 911, then does whatever, knowing you'll get there in time to save him and get all the attention in the world. One guy gave us the wrong address after he moved. Luckily his former neighbor knew where he moved to. Or the drunk guy that goes in the bar, sits, down, has a couple more shots, then downs a handful of "red pills" making sure everyone in there see's him do it. Almost every time it's Tylenol. Have you ever been tempted to write a book on how to commit suicide?

Two women drunk on Breezers?? No way. What light weights. :roll:

Sometime's it's the "simpler skills" that can trip you up. Unfortunately you do have to learn things you don't want to learn or want to do. I know, it sux. I'm always amazed when someone says that they went EMT-A, to EMT-I, to EMT-P in 12 to 18 months. And I've seen some of them struggle because of that. It use to be you had to have three years as a "A", to get into a "I" class. And had to be a certified "I" for one year to get into a "P" class. So a minimum of four years. I'm not going to go into detail all the other criteria needed also to advance. But, I know a lot of Basic's that can run circles around some paramedics, especially with a trauma assessment. And yes, it's true when they say EMT-A's save Paramedics. But a good Paramedic should save and support Basic's and I's also. It all comes around

There's a difference between proficient and adequate. You can be adequate at what you do but not be proficient enough to advance. Clear as mud? And yes, there are those that I've seen that have been adequate for years. But I wouldn't put them in back by themselves. We had one guy that always complained because after five or six years he was never scheduled as a Crew Chief. I asked him, "OK, what's JVD or what is COPD?" He couldn't remember...

Geesh, all you guys are good. =D> There's not much else left for me to say. I'm sure things have changed somewhat, but sometimes you do have to remind them that classroom and field training are two separate areas that you have to mesh together. Even if you have to explain, "OK, you're done with the class, now throw the books away and we'll learn the other stuff."

Let me ask one question in regards to field skills. Do you benefit from Field skills as an EMT when you get over 500 hours of field skills in your paramedic program. What kind of field skills are we talking about here? How to immobilize a fracture? How to put oxygen on someone? How to cover a wound? I'd risk it to say that all those skills can be gained while in paramedic school. ----------------------------------------------------------------------------------------------------- Uh, sorry, Ruff. But...Those are skills needed way before paramedic school. There's not enough time as it is with pharmacology, ACLS protocols (and cert.), you know, advanced kind of stuff. You MUST be proficient with the previous level before going on. And there are people out there that may have the hours, or even years of experience, but they lack the proficiency to advance, and they shouldn't be. I know there are those "old timers" there like me that remember that you had to be "nominated" to go on to a paramedic program. You just didn't get in because you wanted to. (I'm all finished now)

A quick, easy, thing to consider. Don't take most things personally. Who knows, maybe they were treated in a less than positive way when they started out. And yes, there are those who don't know how, or like to field train. But there are those who love to do it. I myself am one. If someone messes up or has trouble I'll work with them anyway that I can. When doing ACLS or MICN I'd have a long line for testing, because they knew that if they failed the first time that by the time they left my session they would know exactly what they did wrong and what is right. Not everyone is that patient in EMS. And if you do screw up, don't make up excuses, don't lie, and don't defend yourself into an argument. Then it will become personal. (Hopping off my little box)

Pick me, pick me, I never get to go! I've got the vest and everything.

I didn't have time to read each and every post on this subject so I might be repeating someone else, but. Basics through Paramedic (or even higher) is all a team effort. One suppose to support the other. As far as advancing, I'm a firm believer in that you have to have "book learnin' "-classroom, clinicals, etc. AND "field learnin' "-actual hands-on experience. It always worried me when someone would advance without being proficient field skills. And that takes time. You can't rush it, no matter how much you want to.

That can ruin your weekend. I've got pix somewhere of a camero rapped around in a horseshoe somewhere. The guys boot left in the wreck gives a nice touch. Of course I'd tell folks his foot was still in it, nope, just kidding.

HELP, I've got blood in my alcohol system!!

I'm camera shy.

When I was working at a private ambulance we were sitting around playing cards and listening to the scanner of a car chase. We knew they were close. We heard one squad car, "Appoaching 17th & Perkins", almost immediately we heard, "Approaching Perkins & 17th". :shock: Then we heard the brakes right out front. They did miss each other.