JTpaintball70

Three flights in less than 24 hours. Spent less time in my base city than I have in the air and in other cities.

I would say it was snarky or ass-holish, there is nothing in the OPs post to suggest whether they were taking the EMTB, EMTA, or EMTP test, they just said they failed the NREMT exam. Yes, it was probably EMT B, but who knows. Maybe this is why this site is dying ?????

Actually if he's a newbie and taking the NREMT exam, that's EMT-B. They are making sure newbies know the new titles (NREMT, NRAEMT, and NR-P).

ACtually you can take NREMT six times. You just have to take a refresher course after the third attempt, which you'll have to pay for as well. So that's 70 per test attempt and however much (usually 100 or more) for the refresher.

And I didn't see any snark. The rules are laid out pretty clearly from NREMT for anyone who bothers to read them.

EMTLife is doing ok. Most other EMS forums I've noticed are slowly losing active participants

I remember YOUR name, JTPaintball70. Don't recall your last posting, so it must have been a while.

Quite a while. Been spending most forum time on another EMS site.

Havent really been ti this site in a long time. I do see names that I remember though

Never worn a badge in EMS. Hopefully never will. Our uniforms look too much like law enforcement to begin with.

My primary unit I work in is set up for a single seat on the passenger side and another on the driver side of the box. I like it a lot more than a bench, especially due to provider safety if involved in a TC.

You might want to check out University of NM. They have a BS in EMS in a few different concentrations. I'm not sure if they'd take your current AAS +medic cert, but it's a good place to start by asking a few questions. Mary Hewit would be the one to talk to I think.

Our portable suction is not in our first in bags because it is a standalone item taken in on certain calls.

Anyone else find it slightly concerning battery powered portable suction is not part of more peoples first in equipment?

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It depends on the individual, is EMS experience essential to be a manager ?

I would hazard a guess that it would be helpful understanding some of the daily requirements as in peak hours, and the politics.

cheers

I've seen worse politics in the hospital I worked at than anywhere in the EMS field. And someone who has been a LEO administrator, for instance, could probably do a good job as an EMS admin. I think if the person who wants to be the admin has experience as admin, then they would most likely do a better job than most street medics who promote to supervisor with no additional training or education as an administrator.

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I basically use DCHARTE. HEre's a sample narrative.... lets say a 25 year old male found unresponsive by family in their bedroom.

Medic 2 dispatched code 3 to 124 Everyplace Lane for an unresponsive.

U/A pt is found to be a 25YOM who is unresponsive to outside stimuli.

PHX: As noted above, per family. (on my software that's a separate list, and lets say in this case it's IVDU, DM1, Asthma, and migraines)

HPI: U/A of EMS to scene, it appears that a mid-20s male is lying LLR on his bed. There appear to be no bottles of any medications or social substances around the patient. Patient appears atraumatic in presentation. Family asked for history on patient. Family states that the last time they saw the patient acting normally was approx 3 hours ago. Family prepared dinner and came to get the pt approx 20 minutes ago, and that's when it was discovered that he was unresponsive laying in bed. Family states he has been eating normally, and taking all prescribed medications on time and w/ the correct doses. Family denies that the patient has been ill recently, had any falls or injuries recently, and states his mentation has been normal. Family states nothing like this has happened to him in the past.

Mentation: GCS 7 (1-2-4), A&Ox0/4 (none due to unresponsive)

Skin: Cool, diaphoretic, normal coloration, good turgor.

HEENT: Pupils equal and reactive to light, 3mm. No fluid noted from ears or nose. No tenderness, crepitus, or deformity noted on palpation. Airway appears intact, with no snoring respirations.

Chest: Breath sounds clear and equal in all fields, normal depth and effort. No crepitus noted on palpation of ribs.

Abd: Soft, non-tender in all quadrants by palpation. No pulsatile masses noted on exam. No signs of trauma.

Extremities: Withdraws from painful stimuli, distal pulses present in all extremities, strong and regular. No gross trauma noted. No signs of recent injections.

Primary and seconday assessment performed. CBG reading obtained by EMT-I JT, reading of 'LOW' returned. Vital signs obtained by EMT-B Other Guy and as noted above. 18g IV established by EMT-I JT, R F/A using aseptic technique, 1 attempt, success. Running TKO NS on macrodrip set. No signs of infiltration noted around IV site, secured in place w/ Veiniguard and tape. 25g of D50 administered SIVP by EMT-I Zecco, attention paid to IV site watching for infiltration or any adverse affects, none noted. Upon successful medication administration, patient became to come around and became aware of surroundings. Patient was reassessed, and he stated that he gave himself his dose of insulin before eating, thinking the meal would be ready before it was. Patient states he is feeling much better now, EMS maintains their present location while patient eats dinner. Patient states he would rather not go to the hospital. IV is D/Cd, site covered w/ 2x2 and taped into place. Patient is told that EMS would prefer that he go to the hospital, and that there could be consequences of not being seen by an MD, up to and including death. Patient states he is aware of this, and signs refusal form. Pt is now A&O4/4, GCS 15. Pt is told if he starts to feel ill again, or if anything changes he is welcome to call EMS back. Patient states he will follow up with his PCP in the morning.

Medic 2 back in service from scene, en route back to quarters.

--------------------------------------------------

That's a sample of how I do reports... That call is completely made up and has no bearing on calls ran here in my AO

EDIT; Our E-PCR software has a list of 'events' which is where times for the procedures performed on scene are located. It means I only need to list what we did in the narrative, and not have to worry about putting times in it as well.

Sounds similar to the setup in Denver, CO. DFD has medics but they operate as BLS only, with DG being a semi-private service that handles transport duties for 911 in City and County of Denver. IT seems to work well, but then again the hosemonkey don't want to be on scene with the patient by themselves so there'd never be the FD having the ambulance get there slower.

It does sound like a ridiculous idea to have the bus standoff farther just so the FFs play EMT and get their handson time that way. I agree with making them do at least 1 12 hour third ride with the transport service a month.

At my service, I don't tend to fit in. I also do not trust anyone. Until they prove they deserve to be trusted they don't get it.

All this talk makes me happy to work for a municipal third service. And since our town doesn't waste money by paying firefighters and none of our vollie ffs are EMTs... we don't have to worry about the form trying to merge us.

Ive dropped an og tube on one of my trauma patients I intubated, but I'm the only one at my service to do something like that.

I tended to use our whole cot. With the patient properly secured there shouldn't be any problems getting them up those stairs.

I've been wearing Converse 8" Tac side zip boots for years and love them. The most comfortable boots I've worn from day one and great for long shifts on my feet (I worked as a floor tech for almost a year and wore them everyday). They usually last around 2-2.5 years a pair.

This is one reason I like Canadia's naming scheme for prehospital providers. Everyone is a paramedic of some kind. That kind of naming convention is something that would simplify things. Or if medics would stop getting annoyed at being called an 'EMT'... Although that is changing anyways with NREMT dropping EMT from the Paramedic's title.

My HTC hero stays in an otterbox, so decon is relatively simple. After every call it gets wiped down by cavi-wipes just like my steth. And every week or so the box here pulled apart and soaked in bleach water mix for an hour or so. And since we use personal phones to call the ed anyways, its almost always in my hand for a call

As for finding it faster... maybe. I know when I finally get my medic I'll probably at least make up a little bound flip book at kinkos with at least drip charts on it, and have it laminated so I can right on it with the sharpie I carry.

You know, I don't disagree with this, as I did it for a few weeks. But what did you do about decon? I found that I spent way more time with my hands on my phone than I liked and wasn't confident that it was even possible to decon it in anything other than a feel good sort of way.

Plus, I could find things in my cheat sheet faster..grin.

Dwayne

If all I saw was the strip, I might be puckering up and reaching for the pads... I kinda wanna know what Dwayne was asking too. Looks to me a like a V-tach.

Welcome to the City

I'd say go for your RN first, then if you want to later become a medic. Working in a hospital isn't quite as bad as you make it sound, especially if you get hired down in the ED (coming from someone who tech'd on every floor of a large hospital in NM). I'm doing it a little backwards as I'm currently a medic student (or will be come Weds ) who wants to go one to get his RN and eventually become an NP in the ED. If I could switch around the order I'm doing it in I would in a heartbeat.

When I first started I carried a green spiral bound paramedic drug reference and the Informed ALS field guide usually in my pack just in case I needed to look something up. I see no problems carrying one to refresh you memory on something that you don't use every day. I see a problem if you have to refer to the guide for every call even on simple things however. But something you don't use often on a call at 0300 is a good time to look it up to double check that you're giving the right doseage or drip rate (I do this wiht Flumazenil almost every time).

I know now that I use an Android phone I have one 'home screen' setup for work use. It's got phone number shortcuts for PD dispatch, county hospital, city hospital, along with Epocrates, Informed ALS app, Skyscape med-calc, and a few other apps so that I can get to them at work quickly, and not have to carry those books around.

If you're worried about carrying those books, and you use a smartphone (Droid, iOS, BB) consider looking for the Informed apps in your app store. Those and a few other apps all on your phone means you've got all the reference you'd need at your fingertips in one easy package that you probably already carry around on all your calls anyways.

If it's like most flight agencies you need 3-5 years of high call volume paid ALS service along with PALS, ACLS, PHTLS, FP-C, and a few other alphabet courses to even apply.

Oh yea, also an SVN, NRB, and NC. O2 is on the cot.