under-dreaming

It is apparent that the money seeking corporate EMS systems are the major problem holding us back. I wanted to work for an ambulance service that was all EMS, no fire. But when I realized the wages they pay Basics in the region I lived with AMR, I was disgusted. I could make that much flipping burgers, and I have a family to take care of. It is embarrassing. And the public doesn't even realize that their emergency responders are paid so little. Fortunately, I found a fire service that is primarily an ambulance service. Unfortunately, I had to move to a different state to find it. It truly is a great situation that I have with the city fire department. We are an EMS minded fire department who puts fires out sometimes, and we know it. Federal programs are great. Federal control is not great... at all. But when a state gets the proper funding then the county/city can get the proper funding. Ideally, it all starts federal. Do I want a politician in D.C. telling me how to operate in a town that they have never even heard of? No way. In Alaska, there is too much money circulating. This is due to the cultivation of natural resources. Because of this, city/state employees are able to budget in a fashion that is productive to growth. Therefore, the Alaskan model is going to be in a different category than the lower 48 states. But because of the existence of the Alaskan model, and the EMS system available here, the government can see the potential for other EMS systems when there is a little extra financing in the right department. I'm not trying to say that Alaska is a brilliant, spotless EMS system. But the fact remains that I am making more than twice as much to do the same job, and all training is paid for and highly encouraged. There is such a thing as effective EMS without corporate attachment. I hope that whatever funding is available in the Obama administration is able to find a good home; and for those who need it most: speak up and speak loud, otherwise it may never find that home.

It is my understanding that the EMS system has come a long way since its inception forty years ago. To really make a difference on the administrative level of EMS there needs to be more people (perhaps more like you) who have the desire to see a big change in the profession. It can happen. My circumstances are much different from yours and others in the country. I still am not sure what you were saying by throwing Sara Palin's name in the mix.

Forgive me, I'm not quite sure I understand what you are saying.

It is likely that through the passing of time, there must have been some errors of omission and commission from the patients mother. Perhaps she didn't tell the story accurately to the paramedics on scene. It just doesn't make any sense for a licensed paramedic to tell somebody that the kid doesn't need an ambulance after a television fell on their head! We all know that there can be more than meets the eye in those types of head injuries, which is why nobody with that kind of training would do such a thing in their right mind. Likewise for the medical clinic. If they were given an accurate depiction of the events, they should have acted differently. As for the public apologies from the hospital... sometimes businesses like to go with "the customer is always right" principle... it keeps patients walking through the front doors. My gut is telling me that the mother is looking to make some money off of this. Money has a funny way of making people exaggerate things.

I noticed you are from Redlands. I just got my basic from Crafton Hills. Is that where you went? The respiratory complicatios are actually pretty easy to understand if you try a little experiment. Try sitting down and breathing a fraction (perhaps 1/2) of your normal volume. Then stand up and do some jumping jacks while breathing at that same depth. It is very likely that what you experience is similar to the person with one lung, depending on the condition of that lung also. People live with it. I believe that the bacteria causes some sort of irritation in the lower airway.

Well considering I am a firemonkey... In a small community like the one I work in, we can use all the help we can get. And so far, we have caught a few good breaks. I don't know the funding protocols behind other city/county/state run EMS departments, but I assume they are more eligible for federal/state support than a privately owned ambulance company/corporation. The state of Alaska has been very generous in terms of EMS support. As for overpriced fire response vehicles? We don't set the price tag. When it comes to being prepared in a place where you are your only additional resources, doing the job right can cost a lot of money.

http://www.barackobama.com/issues/homeland...urity/index.php The link above will take you to President Elect Obama's web page on the topic of homeland security. This is one of the excerpts: Support First Responders: Barack Obama is committed not only to rolling back the Bush-McCain funding cuts that have affected our first responders - police, firefighters, and emergency medical professionals - but also to increasing federal resources and logistic support to local emergency planning efforts. I hope he's not full of it. This could be a good thing.

My department is actually more like an EMS based fire department! This is the only fire department I've ever worked for, so I really don't know any different... All of the paid staff here are primarily EMS responders (it is just what we do most of the time). Personally, I spend most of my mind-effort on EMS related things, and that is what most of the guys here are like too. We also direct most (if not all) of our finances towards EMS related endeavors. It's a great system if you live in a small rural community like I do. Our department is also volunteer based. And although many of our volunteers are certified emergency responders, many of them are not... so you can guess that their priorities are in the fire aspect of the system. I guess if there is anything that I can offer to the discussion with my situation, it is that there is a way to co-exist in a very productive way. Once again though, this is a small community, so the needs are a little different.

Sounds like a good gig. The likelihood of getting caught in the middle of a gun fight or held hostage is pretty high though. But hey, nobody said this was supposed to be a cakewalk job.

I moved from So. Cal. to Kotzebue, Alaska (above the Arctic Circle) about six months ago. You remember how we were taught to make sure the scene is safe before making pt. contact? Well up here, the scene is not safe! This brings a whole new dimension to dealing with outdoor trauma emergencies. ABC's, c-colar, and load up! We have to really be aware of the dangers involved with possible hypothermia in our pt., not to mention incredibly uncomfortable coldness to our hands and face! Good Luck.

Truly amazing! Thank you for posting the link.

There is no doubt about it, we have been conditioned to want to be the best, to get good grades, to get better scholarships, to have more friends, to do a better job, to make more money. We can tell ourselves that it is a natural human condition to exhibit these behaviors (and that may just be the case), or perhaps the social condition that has erected itself around us is a big part in our egotistical mindsets. I'm referring to the competition that we surround ourselves with, such as sports and politics. Even the friendly competition between classmates that can help us do well in a class. Ego brings us to the bar at night to drink our friends under the table, or to pick-up a date. It may also be seen that the ego has encouraged great minds to invent great things. It appears that the ego is also responsible for some negative things as well. Like itku2er said, the ego is the negative side of pride. The kind of pride that will never admit defeat, or give up on a fools argument. Which is the kind of stuff that can drag down the development of the bigger picture. In fact the ego can shatter the big picture, and create a selfish world-view. The ego reminds us why we are all different, instead of what makes us all the same. Where do we go from here? -Kiel

The reason that I feel this is important is mostly for personal philosophical reasons, although I am sure that everyone can benefit from the perspective that we can all bring to the table. You see, everyone has a unique way of looking at the job that we perform. Many of us have developed techniques, both physical and mental, that help us do our job better. There is a large part of this career that is not learned in EMS textbooks. I am referring to the psychological aspect. When I went through my basic course, there were a couple chapters that discussed stressors and healthy habits for dealing with situations. But those are just guidelines. I suppose in an effort to gain perspective, I am simply doing this because I wish to learn through the words of those who have experience. There are over 20,000 members of this site (of course many don't actively do much), and all of that adds up to thousands of years in combined experience. The human mind is not something that can be easily understood (understanding is of course subjective, therefore we may never truly know the mind or the way it works). I chose to ask about the ego because it is the ego that defines everybody. It will define you in its presence as well as without. So far the bulk of the answers here have come from humorous angles (the eggo bit was a good one, I really should have seen that one coming!). These answers are still very telling of intention. Not necessarily bad or good. And it is helping me shape a model in my mind of the mindset of the professionals involved with EMS. I hope that it helps all of you who are reading and replying as much as it helps me. -Kiel

I do appreciate everyone for reading and responding (even the funny ones). And medic_texas has made me very hungry! And thank you itku2er for posting on a more serious note. Mr. Collins, I wish you good luck in your plight to avoid Wal-Mart girls.

I would like to know what the EMS professionals on this site think of when they think of the ego. What is ego? Do you ever think about the ego? How does working in this profession affect the ego? How do you eliminate ego? I am curious to see if anyone will read and reply to this one. I feel like it is important stuff though.

I am still new to the profession. I often times just pump it up to 200mm/Hg and go from there. Or, if it is a medical call, many people actually know their usual blood pressure, just go 30mm/Hg above that. During my first ride out, the paramedic who was watching over me had me take a B/P on someone who had an IV in their arm about two inches distal to the anterior portion of the elbow. I was actually able to hear the B/P through all of the tape holding the IV in place. There isn't a lot of options for us in the back of the rig when it comes down to retaking B/P after a failed attempt. It might be a little off, but not so much that you could miss a life threatening condition. And remember: Treat the patient, not the machines. -Kiel

It is true, Ruffems, it is not purely a result of bad parenting. I did in fact hastily point my finger at the parent in my first response to the topic. It is important for me to express to you that I do not think that you are a bad parent for allowing your son to play in the playground without his crocs on. My wife was the same way when she was a child, never wore shoes. I would like to revise my list of who I really think is to blame for this incident. 1. The city. The city is responsible for using our tax dollars to maintain and keep these facilities clean. It seems that the reason for switching to the safety mats was a matter of ease of cleaning as well as what they would consider improved safety standards. 2. The companies that manufacture the safety mats. For making those things BLACK!!! Or other dark colors that are known to absorb heat energy for that matter. And also for taking advantage of a situation that probably got them unreasonable amounts of profit. 3. The city (again). For not regulating the color of the mats. For not considering the heat absorption of the mats. For not posting signs pertaining to the heat absorption of the mats in plain sight of those who will be using them. In essence, for not taking the time to make this transition into safety mats, a truly safe one. 4. The consumer (mostly parents). For not addressing this type of situation earlier/before a child burned the hell out of their feet. I am referring to addressing the issue by writing to your city counsel, or generate a rally for the issue, get on the news or whatever else you can think of. What I mean by this is that we are strong, able, and beautiful creatures; if something needs to be done, we have the power to do it. I would also like to thank you, Ruffems. For bringing it to my attention that it is too easy to rest on the quick judgment of pointing the finger at bad parents in situations like this. Especially when there are so many hands in the pot that created this situation. -Kiel

I would have never imagined that the big heroes who rescued us from all the unknown stuff in the sand and dirt could forget to take into account the sun's energy to heat those pads up! I must admit, I didn't consider that either (the playground had dirt, grass, and sand when I was younger; so I haven't had the pleasure of experiencing the new rubber floors). Perhaps this is a lesson for us: There are many things that we can do for our children to make their environment a safe place. A "safe place" is really just a state of mind though. We thought the sand box was safe, until children started getting poked and cut on broken glass and used needles; but before the danger presented itself, we were in a "safe place". Accidents happen. Accidents happen in safe places too. A three year old doesn't have the experience to understand that they are in trouble until it is too late, and they don't run as fast when they need to make a great escape. This is not the fault of the maker of the mat. This is negligence from the child's parent. It would have to be a pretty hot day to facilitate the kind of heat that could generate third degree burns. This child's parent should have kept what we like to call "A high index of suspicion" for all of the things that intense heat can do to a three year old child. Dehydration, heat stroke, minor to severe burns from certain surfaces. I would be out there with my kid, playing with him and helping him anyway! Especially at that age! I wonder what happened out there, that the parent could not scoop the child up at the first sign of distress. Whatever the particulars may be, we should remember this: Just because there are "safety" mats on the ground, that does not necessarily mean that the scene is safe. I hope for the best with that poor child. -Kiel

It seems strange to me that this discussion is even happening on EMT city. As health care providers, it is imperative that we maintain a neutral attitude towards alternative lifestyles when we are doing our job in order to provide the best care to everyone. And the same goes with firefighting. When someone spends time considering the negative actions/history of a group of people (groups that are seemingly created by skin color), and create judgments on those groups, it can easily cast a cloud on your work ethic when dealing with those groups that you think you have a problem with, or likewise have a problem with you. And it is easy to say and believe that you will not pass judgment when that time comes, but I think that the subconscious is a very powerful thing, and if you commit yourself to believing that these boundaries exist by paying more attention to the things that we believe make us different, instead of the things that make us the same, we will continue down a path of biasness, which will affect our actions and thoughts. Forgive me if this is to radical to get into... I just don't care for racism. And I can honestly say that in the past, have have in fact seen the impact of racism (both towards me and radiating from me), it is not productive. There is no reason to let your ego get jealous just because someone uses a word that we were told not to use. -Kiel

My name is Kiel. I am very new to the EMS profession. I became nationally registered as EMT-B just this last June. I recently moved from Southern California to Northwest Alaska and am currently employed as a full-time EMT/Firefighter for Kotzebue City Fire Department. So far I am loving the profession and I am happy to be part of EMS. I'm hoping to maintain perspective and expand as I read through the discussions here at EMT city.

Their rig must've been in really bad shape. I work for a fire department in a small city in Alaska. We have a good ambulance up here that we run most of our calls on, but if our main rig is on a call and we get another one, we have to use this old run down unit. It's pretty bad... but it will do the job... barely. Well I just can't imagine closing our doors just because we want new toys. It seems really unfair to the community to deprive them of emergency services for that reason... unless the rig was unsafe, or some type of risk.

I believe that there is a serious misunderstanding for these people with addiction to pain medications. Many of these people have become addicted without even realizing that they did. Some even think that they can't become addicted to prescription medications. I know, the notion is foolish... but I have met quite a few people that have such a high respect and appreciation for their doctors that they simply can't grasp the idea that anything from the hospital can actually be harmful. So, it seems that a big part of the problem is as usual: education. Unfortunately, in our profession we really don't have the venue required for intervention with our patients. All we can do is watch and offer helpful suggestions.

I did two ride-outs with Riverside AMR for school (Crafton Hills College, Yucaipa). They were both ALS units so I can't speak for the BLS units. We ran a lot of calls, and they were all pretty good calls, I learned a lot. The EMTs and medics that I worked with were very good people, but I did get the feeling that some of the employees were not happy with the state of things. I am still considering working with them when I am done with school. I heard that it's not just Riverside AMR that has the "no EMTs in the back" deal going on. I think that Redlands and San Bernardino have similar regulations in place now. I am considering working Riverside because it is a huge city with a lot of diversity... should be interesting enough.

It must be difficult to find the time to sleep and eat let alone find the time to study for your tests! I think the best thing that will work for you is to have at least one person from your class over to your house just talking about EMS. The first few tests were hardest for me because the whole EMS lifestyle wasn't part of my life yet. I met a couple of good people from my class and we constantly meet up and talk EMS. We live EMS. For some of us, before this class, we hadn't incorporated the lifestyle at all. We didn't even know what it was. As time goes by, with the right discipline, you will be an EMS provider in the heart and in the mind. The key to that is to make it your lifestyle. Even if your closest friends are not in EMS, just tell them about what you are learning and that in itself will keep it going in your mind. After a while you wont even have to try to remember what you are learning because it will (naturally) become your nature. That is what does it for me, and I think that it will work for you as well.