TheOldMan

Firstly, Thank you for your service to our country.

There has been an issue here in WV over a Deputy Sheriff having a tattoo. I posted a link, just some reading.

http://www.newsandsentinel.com/page/content.detail/id/529293.html

I was under the impression with the online submission, when my STO validated the hours by "electronically signing" his portion of the form, that would be sufficient. I sent them copies of my cards, I did not get a course certificate with my ALS, PHTLS, etc. and apparently a valid card did not suit the needs of the National Registry. I guess it's just sour grapes on my part. None, and I mean none, of the other National Registry Paramedics I work with have ever had to submit copies of their course certificates, valid cards, and a signature of our STO had been approved.

Edit-I can mail them two years worth of certificates, but that would be the size of a small paperback book.

My National Registry card expires on March 31, 2010. I completed the online portion of my recertification, my training officer verified my training electronically, had my medical director sign his part. Today I get a letter stating my "registration is being returned", the National Registry is wanting copies of all my certificates for my 48 hour refresher training. I mailed in copies my ACLS card, BLS card, PALS card, PEPP card, PHTLS card, ITLS card and a copy of my state EMS education record with my printed application with the correct signatures. My question is: Has the National Registry asked anyone here for copies of certificates, or a current valid card been sufficient?

P.S. I had more than sufficient hours to cover my education hours, I am not trying to "cover" anything up, or fudge hours.

Song of the day..

Best DJ, voice: "This song goes out to you know who from, someone north of them.

A&A Breathe

Angels and Airwaves, song called "Breathe"

I am sorry, I do not understand your question. Are you the only ALS provider or are you a BLS provider with no ALS backup ? I am not understanding why you would need ALS backup if you are an ALS provider ?

I thought my OP stated I was a paramedic? Maybe it was confusing. I shoud probably have clarified about the ALS back up issue, I probably should have stated an additional unit, because if the patient "goes south" sometimes extra hands are a blessing. I would be the only ALS provider on duty in the county, I would be partners with a CPR/Driver, and in the only ambulance in the county. I am confident in my skills, and would provide the best patient care that I can. I posted this in rural EMS to get thoughts and input from rural EMS providers who may be the only paramedic within the county.

I am currently a Paramedic in a mostly rural county in WV. My mother recently had a CVA, and I am the only one of my brothers and sister who is remotely close enough to help her with her day to day care. I have an opportunity to accept a job that is closer, and give me more time to help. I currently average 10+ true ALS calls a day, and if anything "goes south" my back up is no more than 10 minutes away here. The position I am looking at pays less, about the same hours, and in this rural setting I am the only ALS provider on duty in the county, so I have NO ALS back up. I am interested in any thoughts or opinions that the city crew might have for me.

Please try to include the 12 lead measurements, pr interval, qrs duration. Could be a LBBB, then is it a new BBB or existing?

Ruffems,

It really depends on what part of the state he is from, some of the more rural counties only have BLS squads. I respond as ALS back up to as many as 3 counties any given day, and one county in Ohio. Our service does training with the BLS only squads to help them understand what exactly is needed from them when we get on scene. i.e. a detailed SAMPLE history, and OPQRST ASPN.

Yes Ruffems, I agreee the OP did make it sound like the state was allowing EMT-B's to "read' 12 lead EKG's, all I wanted to emphasize is that is just simply not true. I have been ALS back up to rural BLS only squads, it does make it nice when I am handed a quality 12 lead tracing when I get there.

Welcome emtmccall to the forums.

Hello form North Central WV alot going on in WV EMS eletronic pcr, EMT-I program, 12 lead EKG for EMT-B so drop me a line and let me know what eles is knew in your state

Yes the electronic PCR will be here soon. The state has just developed the EMT-I protocols within the past year, if I remember correctly it is the I-99 standards, I am not even sure where the I-99 classes will be held, I dont know if it will be a RESA Public Service Training class, or I hope a college level class.. As for 12 lead EKG's for EMT-B's, I am pretty sure they are allowed to acuire the EKG, with training and the Squads Medical Director blessing, but unless they use telemetry to transmit the EKG to the ED, and the ED may determine if the MCP wants to you to divert to a cardiac cath. center. EMT-B's ARE NOT allowed to "read" the strip, lead placement, STEMI recognition, these skills are just simply not taught at that level in RESA classes.

Yes, Terr, it was a wonderful evening, your hair glistened in the moon light, your eyes sparkled with passion. What a weekend to remember. We should name the girl, itkManer. Night sweets

I purchased my work pants from aspenmills.com. I have a pair that is 7 years old, and look just as good as they day I bought them. The pants don't tend to fade, after they have been washed several hundred times. I recommend them highly.

I was trying to visualize what he was describing, that was the only thing I could think of.

Whether or not they pay, doesn't affect me either way.. So, I don't and I won't discuss payment terms. We use a third-party billing agency. All of that is between the patient, their insurance and our billing agency.

Do you work for a tax-based service? If they don't pay, how does your company make money to give you a pay check?

Is this what you were trying to describe?

If we are doing a routine transfer, and the patient is deemed to be ambulatory in their physicians eyes, and the patient is a medicare patient, we are instructed to provide them with a cost, and make the patient aware by signing a ABD (Advanced Benefit Disclosure) form, detailing why medicare may not pay for this transport, and informing the patient of the cost of the transport, and asking if the patients still wants transported, having the patient sign the form, and making sure the patient understands the decision. My opinion, if the patient asks, I tell them, of course I may be off a dollar or two, but I am usually close. I feel if the patient asks, be honest and tell them.

Way back in the late 1970's, West Virginia had a 96 hour MICP (Mobile Intensive Care Paramedic) class, a few of the 'old timers', I work with today are only '96 Hour Medics', they cannot sit for the NR tests, but have been paramedics for 30 + years. I couldn't imagine sitting through a 96 hour class, and be thrown in the streets and function.

I just happen to be an ITLS instructor. My advice for you is pretty consistant with what the others have said, read your book prior to the beginning of class. At the basic level; long bone splinting, spinal immobilization, ked (xp1) application and use, patient assessment, helmet removal, are a few things that I can remember for basic level. My other bit of advice is to get an detailed, systematic approach to patient assessment, don't work on C if you don't have A or B done. As for scenarios, there are 3 different types; military, hospital, and pre-hospital. Another bit of advice, our classes are "hands on", if you don't palpate the area, your evaluator may not tell you if you have missed something. So, study, do your best, and you will learn.

I also think part of EMS is the fact no one ever forgets the 'Oops' moments. I was know as the 'bambi killer' for the longest time. Part of me wants to say, if they are teasing you about it, means they 'accept' you. If your co-workers wasn't saying anything, then you may have a problem. We currently have several workers who have acquired nicknames, some of which will get me thrown out of this forum if I were to repeat them. The other point to barefootedkiwi, does you company provide you with an EVOC class, we have an EVOC class every year, mandatory for everyone. The class is a good reminder for things you might forget, and the driving part is fun.

I have hit a deer, but no signs.

Hi,

I recently took the NREMT test and unfortunately failed. I did really well in my state EMT class and passed with flying colors. I am not sure what happened. I know that we all had to wait for three weeks until we were even able to pass the test and I start ed a full time job and had a lot on my mind.

I am not making excuses just trying to give you the whole picture.

I want to retest but I am concerned about not passing again . I want to be an EMT and I want to work in EMS.

Does any one have any thoughts or advice on this situation?

Thanks!

WLSC2008

WLSC,

Haven't had a chance to follow up with your question until tonight. Have you retaken the exam?

Probably they want you to know that D-50 is to correct Hypoglycemia, when you begin to work through your H's and T's.

Well lets see, about 11 years ago, I started as a Vol. FF, through the department I had my first EMT-B class paid for, and passed. I had a year or so under my belt, and managed to get on a paid service. I agree that sometimes your family suffers, my personal experience was; lack of holidays, lack of sleep, divorce (yes the D-word), spent my time doing countless transfers, mixed in with some emergency calls, then with seniority made it to a "911 Truck". Two years ago, the local college started a Paramedic program, I made it through the program, and passed the NR test. I was probably the hardest two years of college, I spent 4 in college right after high school. Lets say you will not get rich in this profession, if I had to support my family on what I make, I would need to have 3 jobs, I have 2 now. I would ask the people in your area, what exactly the steps are, because it varies from state to state. If you do decide to get into a program, commit yourself to the program, read anything and everything you can get. There is a computer term GIGO (Garbage In, Garbage Out), so, do get a quality program and a quality education. Also, never stop learning, when you feel you know it all, it is time to quit.

So, ponder this. When you go to work, do you put everything in a pouch on your belt, or cargo pocket? I put my shears, penlight, ALS field guide, and ears in my cargo pocket.

I am from WV, and I am familiar with the EMT-B protocols. NoOnesAngel

stated she could give Epi, that is only with a Epi-pen or Epi-pen Jr, only after getting medical command approval. Albuterol can be given by a BLS squad only, if she has her medic partner driving, Med Com, probably won't allow her to administer the Tx. My suggestion to you would be, the next time your 'lazy-butt' medic partner is driving and you know your patient needs more care than you give in your BLS scope of practice, get on the radio and request ALS back up. I will also say WV, is probably about 20 years behind in updating ALS and BLS protocols.