crotchitymedic1986

The smartest thing that you can do is to visit with an existing honor guard in your state, or neighboring state. I have never met any honor guard folks who were not willing to bend over backwards to help a department do it right. If you are not sure who has one, start with the bigger city or county services (usually Fire) in your state. In a rural environment, sometimes it is better to create a 2 or 3 county team so that you can share the expense and ensure that you have enough people to perform the duties necessary on short notice. Also, I would not give out uniforms until people have practiced for a long time, this is the type of thing that people will immediately sign-up for, but then stop doing because it requires more work than they realized.

I know that no one in this room would ever let a patient lie on a sheet or pillowcase that was used on a previous patient, but what about your coworkers ? Be Honest Now.

I do not believe that it is mandatory, I believe that it is highly recommended, but that could vary from state-to-state, country-to-country. Here is someone else's opinion:

http://www.vaccinetruth.org/tb_testing.htm

1. The question would be why are you transporting a patient who can walk, that is insurance fraud. It is stupid to use your back to move an ambulatory patient, or to ask someone that is elderly to slide side to side when they can stand and pivot.

2. You are transporting the patient from the hospital, there is no emergency, you can read the chart on the way to the residence and get all the info you need.

3. You drove through a red-light, and the camera went off ---duuuuhhhhhhhh

Sounds like she is just responding to your incompetence. No one can make you look stupid, only you can do that; dont blame her for noticing.

I think all of us by now have read, seen, or heard about the conspiracy theories that abound about the events of 9/11; do you believe any of them ? Have you watched the French Documentary; if so did it raise questions for you ? As far as me, I do not believe that Bush/Cheyney/or the government was complicent, but I do believe we shot down flight 93 over Pennsylvania; which would have been the correct thing to do at the time.

you answered your own question when you said your volly department had no rules or regulations. GET SOME. It does not matter what they do anywhere else, your organization needs to become professional and set some standards. Otherwise you are all opening yourself up to a huge liability.

no havent made it out yet --- and another suggestion, the 20th anniversary DVD of Eddie Murphy's Delirious standup came out last year I think -- for the young folks who missed it, the funniest stand-up of all time, his sequels sucked. Can anyone say goonie-goo-goo or ICECREAAAAAMMMMM

OK, here we go again. Lets step out of our box for a second, and ask what is the minimal an ER Doctor would do before he would "let the patient go", and like it or not, the patient has presented to you for care/evaluation, whether they called or not. If I put on my crocks and a spaghetti stained scrub shirt on (crotchity MD), I think I would do the following:

1. Atleast a Blood Alcohol Level (cant do that on the ambulance)

2. A Drug Screen to make sure alcohol is the only culprit (cant do that on the ambulance)

3. A glucose stick (we can do that) followed by a chem panel (electrolytes), possibly ABG (to prove not hypoxic -- cant do either on the ambulance)

4. Now if he has no signs of trauma and denies trauma/fall, I probably wouldnt do a CT Scan or MRI, but we all know Docs that would and do (cant do that on the ambulance).

So if ER Docs, with all of their training, arent comfortable releasing drunks just because they can stand and can annunciate most words, why are we so quick to say SEE YA !

Every time you leave a drunk behind, you are one step closer to a lawsuit -- your choice.

ruff I loved last american virgin, as a matter of fact just bought the DVD off amazon a few months ago. You have to love the music, and although the ending was sad, it was one of the first "twist" movies that did not end the same old predictable way that all other teen love movies ended.

Also, for male enjoyment only, rent the Wrestler, and see Marissa Tormei nude ---- NICE.

I promise you, the best movie out there, that no one saw is "The Prestige" starring Hugh Jackman, Christian Bale, and Michael Cain. If you love the 6th sense, you will love this movie. Cant give away the details, but it is one of those that as soon as you finish watching it, you have to put it right back in to watch again, as the ending blows you away, and catches you totally off-guard.

Ok let me ask these two questions

Please answer both questions separately. Please do not put them both in the same context.

Would you support "Free" healthcare for all?

Would you support Increased taxes to fund the "Free" healthcare for all Concept?

[/quote

There is no such thing as "Free Health Care", someone has to pay for it (taxpayers). Just look at how out of budget the Medicare Prescription Drug Program is, in just a few short years. My plan would include:

1. Tort Reform for frivolous lawsuits

2. Make Insurance portable across state lines, the competition would reduce the prices.

3. Deny Insurance companies the ability to deny anyone or drop anyone for any reason.

4. Mandate that everyone get insurance, or take away their annual tax refund check, or make them pay a higher payroll tax, to put in a pool of money for the uninsured.

5. Base reimbursement to all healthcare providers (including EMS) on performance indicators that are related to outcomes.

If you do that, you do not need a national plan. If you do create a national plan, it should just be for catastrophic care, and it should not be free (even if its just $10.00/month, they should pay something). I would do away with Medicare, and use those funds to pay for it, if you have been in the US for 65 years and still can not afford health insurance, you should be deported. Get the lazy/worthless folks out of the system, and we will be better off (veterans excluded).

Ambulance Accidents Jan- July : 117

EMS Personnel Injured: 111

EMS Personnel Killed: 1

Patient Injured: 23

Patient Killed: 5

Passenger in Amb injured 2

Passenger in Amb killed: 2

Other Vehicle Injured: 63

Other Vehicle Killed: 13

Pedestrian Injured: 2

Pedestrian Killed: 1

Yes, please resort to name-calling when you have no historical knowlege to back up your liberal views. The reason we lost in Vietnam, have been in Iraq twice, and are currently in Afghanistan for probably the next 10 years is because we do not have the "will" to fight wars as they should be fought. War is war, and civilians do die in war. If we had carpet-bombed (not nuclear bombs) Iraq back in the early 90s, and fought the war like WW1 and WW2 were fought, we would not have the problems we have today with Pakistan, Afghanistan, North Korea, and IRAN.

You will note that the muslim terrorists do not have any sympathy for civilian life. We have shown up at a gun fight with a knife.

bunch of pu**ies ------- you realize how many of you would have never known your grandpa if it wasnt for the bomb -- do you realize how many of you panzies would have never been born

2nd degree type 2

Back to the original problem ................ your boss is being unprofessional by discussing counseling issues with other employees. I would file a grievance with your HR department or whoever is above him (other chief, county administrator, or whoever controls his budget) --- unless he is the owner of a private service, he has a boss he has to answer to. You should quit and find a more professional place to work.

I dont remember which service did it, but i read it about in JEMS. There was a service that created HomeCare Instructions like the ER has to give out at calls when someone refuses. It was only on the major topics that usually resulted in a refusal: ETOH, Diabetic, Seizure, MVC, Headache, Sprain, Minor Fracture, Suturable / Non suturable laceration, Chest Pain, etc..... I imagine they had a blank/generic that they medic could fill out at the scene for any "rare" things that needed education.

The instructions were preprinted on a single page, and told the patient what they should do, when and why they should call 911 again, and served as proof that you educated the patient about their current illness. I believe they were kept in one of those portfolio folders in the truck, the crew would just pick out the one that was needed. Then I think part of the refusal form stated something like "I have received my Homecare Instructions for my current illness or injury.

Someone who has a jems account could probably find it in the archives.

As mentioned before, since most of our industry's refusals are Paramedic refusals (you dont need to ride in the ambulance) instead of truly patient refusals (I refuse to go AMA), then the more documentation that can have, the better.

You have to factor all costs in and not just hourly/yearly wage. For instance, you can easily make $70k in California or Hawaii, but a 2 bedroom shack will cost you 1/2 a million dollars, and all other costs will be higher: taxes, groceries, etc... Typically, the cost of living in the south is much cheaper, so you have to consider that in your thinking. I know that North Carolina used to have a large volunteer base in their EMS industry, so it wouldnt surprise me if wages are supressed. I have a friend who works in Atlanta, and he claims there are atleast two employers who start medics in the low 50s to high 60s as their base pay, so obviously overtime would easily put you over 70.

Second piece of advice : Dont work EMS jobs for 80-100 hours per week. You could get a job providing sex to supermodels, but if you did it 100 hours per week, you would get tired of it. Same is true for EMS. Look for something different on your off days, even if it is still medical (ER tech).

I would love to see how any medic from any school or employer is going to determine whether or not someone is sufferring from a sickle cell attack ? It can not be done in the absence of labwork. This patient has a legitimate medical condition, and he is not the first to figure out that going to the ER by ambulance usually results in a shorter wait time. Where is the crime in that ?

As dust stated, it varies place to place, but if you wonder why, check this out:

http://www.naemsp.org/documents/characteri...ancecrashes.pdf

It is an 11 year study of fatal ambulance crashes, that pretty much proves if you have alot of violations you are more likely to be involved in a serious accident.

As far as not hiring due to driving record, I turned down several over the years --- My thoughts are that if you can not follow traffic law, then you will probably not follow my laws (policy & procedure) --- and of course, studies have already proved that these people would probably wreck my ambulances at some point. And of course, I would never hire someone with a DUI.

** As far as your specific record, with that much on your record, most good private companies will not be able to hire you, because their insurance will not write you. Obvioulsy as a Paramedic, you could be hired as a non-driver. Your best bet is to probably go with a municipality, as most governments are self-insured, or have insurance companies that are more liberal. I would suggest taking a defensive driving course, as most of the insurance companies that might consider you will demand it anyway. And it might help to improve your driving skills (3 accidents and 2 tickets in a two year period is not bad luck, it is bad driving).

petechia rash, most likely malaria, but could be any infection (or blood disorder from an infection) from a third world country ---- put on the yellow suit, mask, gloves --- ABCs, IV, get to hospital where antibiotics could be started --- decon the hell out of your truck. Dont lick the open sores.

I agree that it is dry, but it is essential. Once you have worked a few disasters you will appreciate how much better it is when everyone is on the same page, versus just cowboying thier way through it. Sadly, since so few departments actually have disaster drills, most of this will be forgotten when the next disaster occurs. JCAHO mandates that hospitals have disaster drills, too bad there isnt an EMS authority that could mandate the same.

Also consider electrolyte imbalances ---- a diabetic who has a dstick of 260, is probably not being very compliant.

Key points that I have not seen addressed --- There is the level of EMT-B that you do not want to do. This level is primarily used by volunteers and fire departments, you will have a very limited scope of practice and opportunities for a job at this level.

EMTI is the level that you should start at, but even then job opportunities are limited. As far as going straight through to Paramedic, I am normally against it, as that is alot of time to invest only to find out at the end that you do not like the job --- but it is getting harder and harder for EMTs to find jobs, so I could not fault you if you chose to go straight through. Some employers will help you go from EMT to Pmdc, but many do not.

Regardless of which level you choose, there are "transport services", services that do 911 and Non emergent, and those that are strictly 911 (private, county, hospital owned). Then there are specialty transport services like MICU for peds and adults, and helicopter services. More hospitals are using medic as techs, and many corporations and prisons utilize us for first-aid. So you can start on the easier end and then work your way to whatever you like.

I would suggest visiting several of your local providers, to see if the chief will allow you to ride third for a week or so (some will, some wont since you are not in school). That way you can get a taste for it and see if it is for you before you invest your dollars.

Even deer are turning white (and note how they treat the brown deers) --LOL

http://www.pbs.org/wgbh/pages/frontline/vi...inwi10s22a3q81f