firedoc5

One advantage I've had is that I've fought insomnia my entire life. My mother said I was five years old before I slept for more than two hours at a time. It was nothing for me to go 32+ hours with no sleep, lay down for about four hours, and go for another 24, and not think anything about it. But I have paid a price for it. I've got more gray hair than my grandmother, migraines, nerves totally shot, and I've been admitted to the hospital three times for exhaustion. It's not fun. Even though I'm no longer in the field I still have insomnia. Have you ever been so exhausted that when you do get down time and you're so relieved that you can finally get laid down that you get excited, then you can't relax?

My best advice is...Respect your body, don't push it to where it is detrimental to your health, physically and mentally. Know your limitations, and respect them. If sleeping is still a problem try OTC Melatonin. It's very effective and much more safe than scripts like Ambien. And PLEASE don't come dependant on meds or even alcohol to help "unwind". This is a subject I've counseled others in the past. If anyone does have further questions or need someone hear them out, PM or e-mail me anytime.

Ok, th I can foresee discontent by the non-paramedics as a wage gap opens and I can foresee discontent on the side of the fire-medics when they're constantly running while Jim-Bob the certified first responder firefighter sits on the couch all day long watching Dr. Phil.

One other thing I forgot to mention is the wage difference. Prior to the 1989 eligibility list, a paramedic would receive $2500/yr as an incentive pay. But as of 1991 eligibility list (more or less the first where becoming a Paramedic was mandatory) you received only $250/yr. And it is my understanding that after the 1996 list there is no extra pay for carrying out Paramedic duties. So the wage difference is not that lucrative.

I believe the requirement was enforced due to a worry that not enough firemen would go commit themselves to the extra work and that would cause a shortage of ALS personnel in the future. So they made it mandatory, then took away the extra incentive to save a buck.

I know many if not most Fire Dept.s require all to become EMT's. That's just common sense. But right after I got on my Dept. full time it was required that all new firemen were required to become Paramedics. Luckily I was already a Paramedic when I joined. But the problem(s) begins, what if someone just can't grasp EMS on an ALS level? What happens when someone is a great Firefighter but can't handle the advanced EMS...they're disqualified?? Or vice versa, what if they are an oustanding Paramedic but struggle with firefigher duties...they're disqualified. At my dept. they had up to three years to obtain their EMTP. Time and time again those who couldn't do their EMS in that time frame had to step down. One argument is that making those requirements more or less weeded out those that were "weak links" and that the one's who could complete it were better well trained...or something like that.

All in all, all you can say is that people never fail to amaze ya. Just when you think you've seen it all, someone pulls another stunt. :roll:

Yes, compression fx of T-7. But the patient wasn't fat. What is was, we were lifting a wheelchair patient chair and all into back of the rig. When the front wheels got caught on the lock-down bar I pulled it toward me. When I did the chair didn't move and my back buckled. And of course, we've all done it so I kept working and finished my 24 hr. (actually turned out to be 32 hr. shift). I was in agony, couldn't breath, etc. When I did finally get to the doc he showed me the x-ray and pointed it out to me. He asked me what did I see. I just said that it looks screwed up, and he added the usual bawling out for keeping on going. Put me flat in a La-Z-boy for seven weeks. That was almost 25 yrs. ago and for a long time that was the part of my back that gave me the least problems. But I'm paying for it now.

It would be great to hear some stories from you [s:bc4e411968]oldtimers[/s:bc4e411968] Pioneers of the buisness about "The way things were"

It would be interesting to hear how the scope of practice has progressed in relationship to education, as well as some "war stories"

I was helping with a seminar in St.Louis quite a few years back for a doctor friend of mine and one of the speakers made a comparison with EMS and the entire medical field. He said that in contrast emergency medicine is still a fairly new science compared to the history of medical practice, stating that those involved in EMS prior to 1990 were considered "pioneers" in the field of medicine. Where he came up with that date I have no idea. It was an interesting presentation going back in history to the time of DiVinci and other "founders" of modern medicine. Wish I still had that on tape.

There are pro's and con's to both. It also depends on the system you are running out of and your location. I really don't think you can accurately pick one over the other.

MANY years ago, it wasn't unheard of to have one EMT and one non-certified driver. I know a lot of privates worked around that to keep over-head down. We had one "boss" that would send two people out if it seemed like it was a routine or crock call, but if it turned out to be an actual emergency they would radio in and send out the second certified person and meet them either at the scene or up the road from the hospital so it would look like there had been two certs. on board. It's amazing how things use to be ran and thank God it has changed.

I had always been told that G.O.M.E.R. was: Get Out of My Emergency Room

The first I heard of GOMER was in the book "House of God" refering to the ER, but I guess it could be used for either.

Well it probably wasn't the best choice I have ever made... But we basically put on the monitor and continued CPR till we got to the rig, then stopped. No tube, no defib, no IV, just CPR and BVM till we got out of eyesight.

The daughter was VERY insistant on us working him. I dunno if it was the right call to make or not, but I believe if the patient would have wanted us to make it as easy on his daughter as possible even if that meant we bang on his courpse for a few mins.

I guess you could say... When in doubt, do it. By no means was it a bad choice

I took my first EMT class the summer between my Jr. & Sr. year of high school. I was still 17 when I took my state test and passed. I knew I'd have to wait until I was 18 to make an official run. But I made my first run the day before my 18th birthday. The state gave me the one day so the coordinator had a full schedule for that week. I was an easy transport for a CT. But five days later I was in school and got called out on a full arrest. Afterward, I went back to school and made it back for typing class.

Sometimes I think it's beneficial to do both, especially if there seems to be a descrepancy with either one.

Something that I've heard time and time again that makes me just shake my head is to hear someone give a palpation BP with a diastolic reading.

One thought I'd always had is that there needs to be more text books out there that incoporates the academics and the practicle information from the actual field. There needs to be a happy medium between the two. I've taught some classes that right after the final test(s) are given and everyone had passed, then you tell the students that now is the time to learn what really needs to be learned.

We once had a call that someone was choking on a piece of food. When we got there the "patient" was complaining that it felt like a piece of ham was lodged in her throat but was not effecting her breathing. She was playing it to the hilt though of how uncomfortable it was. Just as soon as we reached the ER she said she swallowed real hard and it went down. She didn't even go in. She went right out of the back of the rig and proceeded to walk next door, to the mall. We came to the conclusion she just didn't want to walk from downtown.

Now don't forget the GOMERs, Get Out of My Emergency Rig. Every now and then we would ask the ER on the radio asking to run a "Porcelein Level". Letting them know it was a "crock" call. I'm sure I can think of a few more.

I don't have a problem with anyone using profanity. But there is times it is totally inappropriate. IMHO, it comes down to respect. Respect of patients, co-workers, and sometimes society as a whole. Some people just don't want to hear it. Those of us that are in professions dealing with the general public are held to a higher standard, like it or not. That's just the way it is. And yes, there are times things may "slip out". One thing I've noticed is that if you don't use profanity as a habit, the less likely you are to have something slip out at the inappropriate times.

Just one other thought, since I was young I was told that the use of profanity just shows your ignorance of the english language. That has always stuck with me.

Oh man, don't even get me started on NH nurses.

But one thing, for the most part, I've noticed that there are good nurses and bad nurses in NH's, the same as in hospitals. It's just that the ratio between the two are more pronounced.

Probably more truth than fiction.

It wasn't on the radio, but, we had someone call in saying that someone "fell out". A guy (Randy) who had just moved from up north answered the phone. Randy kept asking the caller "what did he fall out of". The caller just kept repeating the same thing. Since being from the north and from a more urban area, Randy was not familiar with someone "falling out" was another way of saying someone "passed out". After they went back and forth about four or five times, we were out the door and left Randy behind. I don't think appreciated it that we left him and as we were leaving, we were laughing and giggling our butts off. Some may say that it doesn't sound too funny, but it was one of those things that you had to be there and heard them going back and forth.

Just remember, there's a fine line between redneck and white trash. :wink:

One transmission I'll never forget is that of a call in on the Trauma radio. We were listening to the call up regarding an individual that was unresponsive. The nurse asked if the patient responded to painful stimuli. The medic (who was not known for his brilliance in the first place) stated "we've slapped the patient a few times, but he didn't wake up". Let's just say we didn't know to laugh or what.

Looking forward to meeting and greeting everyone, slowly but surely.