crotchitymedic1986

New hires, and newly certified Paramedics ?

Rectal D50 is appropriate,you do not need a protocol in my opinion, but if you feel you do, by all means do so. The IO is to IV skills what the EGTA or Combitube is to Intubation skills.

And I did not make any statements about literature, I believe that quote was attributed to me by mistake chbare

Cell Phone versus using radio, whats the difference:

If you are driving an emergency vehicle, you should rarely have to talk on the radio:

1. Your partner can talk while enroute to the call.

2. You can call onscene after the vehicle has stopped.

3. You can call enroute to hospital or 10-8 before you put the vehicle in gear.

4. You can call out at facility after you have stopped.

5. You can call 10-8 before you put the vehicle in gear.

If you absolutely have to talk enroute to the hospital, keying the mic does not require your eyes to leave the road -- texting does require your eyes to leave the road. Anyone who texts while driving an emergency vehicle should have their license (medic and driver's) pulled. If you have no more regard for human life or the maturity to realize the stupid (unneeded) risk that you are taking, then you do not belong in an emergency vehicle.

In researching one of the many ambulance crashes last month, I discovered one where the EMT admitted to being distracted and "looking down", and not at the road, just prior to his crash. The newspaper article did not clarify what he was distracted by, but there is no doubt in my mind that he was probably texting someone or reading a text message. This is probably the most dangerous epidemic facing our industry, not H1N1. Is there anyone who agrees with me, that this practice should be banned ?

Funny you should mention a park inside of New York, one of the great ironies that was expressed in this show, is how the MLK "I have a dream speech" brought the parks full-circle. As you know it was held at the Lincoln Memorial, which is a National Park, but what i had never realized was that the tall white police officer standing at MLKs left shoulder, was actually a Park Ranger and not a State Trooper or DC Officer.

google channing bette or laerdal

Also remember that D50 can be given orally, if conscious enough, and that your average 12oz canned soda has 39 grams of sugar versus the 25 in D50. As stated previously, there are a small percentage that do not have veins, but I will bet that if you followed up on all your diabetic IO patients, you would find that 99% of them had a peripheral IV started and the IO removed in the ER, shortly after you left. It is unethical to inflict that kind of wound on a diabetic unless they are in cardiac arrest, especially when it is not necessary. Quit being lazy, improve your skills.

If you are not watching this documentary on PBS, you are really missing something good (for those nature-lovers among us).

mobey is right, most companies have moved away from traditional yes or no questions, to questions that require you to think on the fly like:

Tell us about a time you had to:

work with a partner you couldnt stand

you made a patient care mistake

take charge to handle a difficult situation

make an improvement at work

break a policy or procedure at work

so on and so on

No way to know unless you find someone who sat through it before, who is willing to share. Best advice possible, is to think of every question that you would dread answering, or would not have an answer for, and then find the answer. Be honest, and dont get diarrhea of the mouth. Smile, look professional, and dont ask any questions that are about how the department would benefit you (pay workhours benefits).

Sex in the ambulance, paramedics with egos and an "I am bulletproof attitude" ; sounds pretty realistic to me.

In this day of cellular technology, it is difficult to not find a parent for a minor. Usually, when this occurs, the minor is at school or day-care, and in most states the teachers/principals of the school are deemed "guardians" for all of the children while on that property, and can make choices regarding transport to the hospital or not. As far as emancipated children, all they have to do is get pregnant.

What we can learn from Fire:

1. Learn how to use your EMS job as just your "benefits" job, while you earn your real money at your private business.

2. Watch porn at work and fart on each other.

3. Dress like a landscaper.

4. Learn how to hide your latent homosexual tendencies (if your painting some rooky's penis with hydrant paint, or making the rookie go naked for some reason or another, I am sorry, you are a homosexual.

I stand by my statement, as most Paramedics have average IV skills at best. Work some time in a pediatric hospital or as a phlebotomist at a busy hospital, and you will dramatically watch your skills improve. Are there some patients who do not have ANY venous access, yes, but most of those are chronically ill to terminally ill, and usually have a port in place. Your average overweight diabetic patient has veins, you just forgot your vein anatomy diagram, and are relying on sight instead of feel. One of the things I always did with newbies was to blindfold them and make them find veins on their partner by feel, with no use of sight. And now that you can buy those vein finding lights, there is no excuse to poke holes in people's bones. 20 years from now, the next generation of EMS professionals will look at IOs like we do lobotomies or intracardiac injections.

People in glass ambulances should not throw stones, I wonder if this has ever happened where you work: Paramedic McDreamy calls out sick because he was out drinking all night and too hung over to come in (or he was up all night at his other full-time job). Captain(s) Whiteshirt are too lazy to get on the ambulance, so we make it a BLS ambulance, or we just shut it down, and then at some point in the day we do not have enough ambulances or ALS ambulances to handle our call volume. How are officers refusing to get on the truck any worse than the Doctor who would not take call for another Doctor; in both situations, patients suffer ?

The patient admitted to taking 20 Aspirin, that should have been enough to transport. When all else fails, you should have "medical control" that you can call (local ER Doc if nothing else)to assist you in making the correct decision. In the future, involve a doctor.

24 hour shifts are dangerous, I can't wait for the day when they are gone (being one of the fortunate ones who was in a 3am ambulance accident because my partner fell asleep at the wheel). If there are any bloated services left that run too many ambulances, I am sure this economy will correct that. With most services running lean, you are probably better off working 12s unless you have a really long commute. If you do work a 24, stay up the whole 24 and sleep on your day off, too me it was easier than trying to sleep 20 minutes here and maybe an hour later on. Your body will get used to the change.

1. At best, your income will be around the 100,000/year mark, so work within that budget to start (start part-time at pay per call instead of per hour).

2. Go to local industry for donations, explaining that when their worker is injured there may or may not be an ambulance to respond.

3. Do bake sales, CPR classes, car washes, spaghetti dinners, golf tournaments, photography packages, anything you can do to raise money and awareness.

4. There are federal grants for rural health care, pursue those (as well as all other grants).

5. Realize that if you got what you wanted tomorrow, your department would most likely cost more than any other department (unless you have a large jail) in your county, so you have to realize you cant get everything you want on day 1; but if you made it happen over 3 years would the community not be better off than if you just threw up your arms in frustration and walked away ?

6. Raising taxes is rarely the successful option, find ways that individuals can donate. Do you have that one guy in your community that has more money than god; what if his large donation meant that the ambulance service was named "James Doe Ambulance Service", or the station was named the James Doe Station. You would be amazed at what stroking someones pride can do for your bottom line (or what if the ambulance had "In partnership with ABC Industries" on it's side ?

There is a solution, but as always it will require alot of hard work. Are you the man for the job ? I think so. GO make it happen

If the patient walks out of the hospital, your efforts were adequate. Sounds crass, but CPR by EMS rarely matters as our response times are too long, and we are not involved enough in teaching community CPR so that the patient can get CPR when it matters.

Its like a Chef who blames his staff for his cooking failures, because they didnt buy the right ingredients. If it is that important, he/she should shop for themselves. If you are serious about saving cardiac arrest patients, you should begin by making the first link of the chain stronger. How many CPR Saturdays has your department had this year ? Teach community CPR so you do not have to do it.

In male patients the superficial dorsal vein of the penis is a better option, as it is always accessible, and has less contradictions or should i say contradicktions ? Of course it means you have to touch a penis so that means the patient will die due to your homophobia.

As far as skills slipping, youve heard me say it a million times, but the decline in those skills is directly attributal to ACLS becoming a "noone fails class". I remember having to strategically place trash cans around the room for people to puke in because they were so nervous about failing back in the old days. The last 4 times I took ACLS, I didnt even crack open the book and never scored less than a 98 -- that is so sad. Create a new class for the doctors who cant pass ACLS, but return Paramedic ACLS class to the old days, and you might actually have Paramedics who can start IVs and intubate.

You may have a much bigger issue to face being an ex-engineer. I had hired 3 employees that were former engineers who had retired early, and then wanted a totally different second career experience. After dealing with today's children that work in EMS, I thought it would be nice to have older, professional, adult employees in my workforce (employees that come to work on time, and dont call out 8 times per year) All four had trouble in EMS, as they could not deal with all the "gray areas" of EMS. They were all used to a rigid black/white or 2 + 2 always equals 4 type of workplace. Not saying you will have that issue, but it is something to consider. I dont think any of the three are still in EMS.

If you have to use an IO, you have poor IV skills.

Edited due to crossing the line...AK

A good thing to do is to meet with local church leaders to discuss these issues, many of which are cultural and not religous, but their spiritual leader will know the answers. There are many cultures where touching a body part is taboo, male or female, or is a sign of disrespect. You can then educate your staff.

Contact the folks at JEMS, you would be amazed at the list of contacts they have, or track the title and see if the original owner is still alive.