CharleeFoxtrot

That's the one thing I'd change, well two. More education which (in my fantasy world) would translate into better wages.

I've have said junctional escape as well and considered atro/pacing. Amiodarone??? D'oh!!!!!

if you say so.

In Michigan, the only drugs EMT-Bs are allowed to give are oxygen and oral glucose paste. They can assist patients with inhalers, nitroglycerin and aspirin if the patient has these already. Not quite sure what other drugs you may be referring to...

Stuff happens man, and I guess it's part of the huge learning curve this profession has. Put that one on your "learning pile"...mine is so tall now I have to climb up on top of the rig to throw things on the top. Had a similar thing happen to me, the call was from a nursing home for an altered. We get there, Pt is on dialysis, cardiac HX, hypertensive and diabetic. The staff says she was 'fine' two hours ago but is now out of it. I asked the right questions-did they do an accucheck? They said her BGL was 194. Did she eat breakfast? They said no. We loaded her up, got a line/12 lead etc. She was a bit hypertensive but not alarming. Halfway to the hospital I think to recheck her BGL. It was 15 . I thought I asked the right questions- but I didn't ask how long ago her BGL was 194, and if she didn't eat had they given her usual insulin dose. I took their word the accucheck was recent-bad move. Of course after some D50 she wakes up and starts screaming....sigh.

First off...relax! You know you know this stuff, and getting yourself all knotted up won't do you any good. As far as the oral stations, the best advice I can give you is to use the paper they provide to your advantage. Write down the time you start the scenario-that's where I messed up when I tested a month ago. I went over time allowed on one of them because I didn't pay attention, and wasn't writing down my interventions so I couldn't even extrapolate the timed elapsed to the hospital. So, I had to do it over. In my program, part of the requirements for graduation was a nice sit down with the head Doc from Med Control/head of ER for one of the hospitals. Talk about getting run through the wringer! It was two hours of questions and thinking off the top of your head. This interview included scenarios, and we used to attack them the same way all the time in practice so we wouldn't freeze. Take your paper and draw two lines, one up and down in the middle and the other across to make 4 squares to write info in. The top left was your scene info...who what where-note the environment of the call. The bottom left was your SAMPLE, OPQRST, etc. and physical exam findings. The top right was for your interventions, bottom right was for vitals and trends. Setting up the squares I wrote "SAMPLE" and filled stuff in as it was given to me. For the vitals I wrote BP HR RESP P/OX etc so I didn't forget to ask the questions and then I could trend vitals by writing them in a column to keep track of them. I had three scenarios: peds asthma, active MI (the one I went 2 minutes over time on) and the retest was a hypothermia. Keep yourself focused, and start with the basics ABC always! Remember rapid transport vs. stay and play, and keep your mind on what can happen next. After each intervention reassess. Overwhelm the proctor with correct info, which shows him/her you do indeed know what you are talking about. The proctors do take nerves into account, and at least when I tested where really great about making you feel that they weren't out to get you. Go over your basic skills, practice them if you can. Remember to look at the autofails and the points. No reason to give points away, repetitive practice of the entire evolution will help with that. Don't have the equipment to practice? Use a friend and a pillow as your patient for the longboard/KED and pantomime it. Sounds stupid, but it does work. Someone else posted up to check youtube, there are some videos there on the practicals, but they are a bit out of date. Watch them anyway, using your checksheets (you can get them if you don't have them already on the NREMT website) and think how you would have done things. A few days before...and this is important...STOP STUDYING. Give your mind a rest, and go into the practicals with a clear mind. If you keep going over and over and over things, all you'll do is get burnt out and doubting yourself. Good luck!

:oops: in my basic class we used "Toilet Paper My @ss" to remember the order of the valves in the heart (tricuspid, pulmonary, mitral and aortic.

8) Nice! (filed away for reference)

Interesting topic. Here in Michigan, Basics are required to have both adult/junior EpiPens and be trained in their usage. In fact, the only other 'drugs' they carry is oral glucose and O2. They can assist a patient administer their own NTG, ASA or inhaler.

To answer the original poster's question if you are lucky, the rush never leaves you. Now there are days when you've only been at the base long enough to drop your gear and sleep is a distant memory when that 15th "general weakness" type call comes in. Well then the rush gets to be more like a muted growl through clenched teeth . But when that general weakness call turns into an active MI you are off to the races again If you feel the need to up your skill level, try and ride more than twice a month or perhaps work out a training arrangement with a local dept or service where you could come in, use the mannikens, etc to keep fresh. A lot of this job is simply repetition that trains your hands and mind to do "this" when "that" happens. Think about trying to learn your skills initially, it took lots of reps until you had those basic skills firmly in your hands and mind. Keeping those skills is a matter of the doing. In order to get through the NREMT-P practical, I had to do some basic skills. Heck, I can't remember when the last was I used a KED board (other than as a handy splint for pelvic Fxs) :oops: so I had to arrange a refresher before I went and did it.

I had thought to start another thread getting people's opinions on opportunities around the country. I know I'm not the only one (due to the bad economy) that is considering relocating and who better to ask than someone already in the field?

You haven't had any training yet? Best thing to do is keep your eyes open, pay strict attention to what you are told to do and learn all you can. Questions are a good thing, just be sure and ask them at an appropriate time. First thing to do is familiarize yourself with the equipment, where gear is stowed so you can help the crew by grabbing stuff at need. Good luck, you'll be fine!!!

Get an anatomy coloring book and some crayons...seriously, it's a great into to anatomy and a fun way to learn.

Nah, I did the smokeater thang in my youth and would be looking at straight EMS. Thanks for the (off topic) info.

Do ya make more per hour there than as a greeter at WalMart? :wink: might be worth the wait

Mid Michigan. Can't speak for the rest of the state, but our area MedCon is a bit narrow minded on occasion. Looking to relocate though, how's the job market out in AZ? I lived in Gilbert when I was a kid.

Wasn't bragging, only expressing surprise

Oh...we have a guy that could gag a maggot! Cripes, you can't even sit on the couch at the base until you've emptied a can of Fabreeze on it. But...what is almost worse is our resident hippy throwback holistic med spiritualist who burns incense that smells a lot like a chicken coop with roses strewn all over it! Wind chill -10 and we have the windows open at the base to air it out. Or...how about finding the 'mystery' source of THAT SMELL coming from the base fridge. Someone's 3 week old lunch that has decomped (retch!)

Long ago in a municipality far far away...a new police/fire/EMS dispatcher was given a call to send out for a male masturbating in a vehicle behind a gas station. This noob was sooo new, he took the advice of an old smartarsed Sgt who told him the word 'masturbate' wasn't proper to use on the radio and that he should instead dispatch cars to the "man in a beige sedan behind the Sunoco at XY intersection who is waxing his dolphin." The dispatcher voiced it exactly that way before the Sgt could tell him he was kidding. The entire county (all on the same freq at the time) was busting out laughing. Unfortunately, the Chief who was monitoring radio traffic from his house wasn't so amused

Sheesh! In Michigan we do 650 clinical hours alone...on top of the 14 month course in order to get certified as eligible to take the NREMT-P exams

Not worried about that at all, the company is well capitalized. I head the union, and am privy to pretty much all of the financial doings of the company and the books are solid. In fact, I negotiated an off-contract raise of $.75/hr for medics and a company wide bonus of $200 (for the basics, dispatchers and wheelchair division drivers) this December in an effort by management to retain qualified people. They didn't have to do it, our contract is firm until 2010. They did it to keep good people, and to attract new ones. Operations employs 110 people, mostly full time so that was a hefty chunk of change. Even if there is a pullback, we being union means there is a plan in place to salvage as many jobs as possible. Regardless, good paramedics are in such demand here that I wouldn't have an issue finding another position somewhere else. I turn down offers weekly :oops: from rival companies, even though I'm still awaiting formal licensure having passed all the reqs. Here, EMT-Bs are a dime a dozen and those jobs might become scarcer. The paid position of MFR is all but dead due to CAAS standards. Those jobs I worry about in any sort of crash if the company has to contract in due to pressure. Also, overall here EMT-Bs make slightly less than your average WalMart greeter as it is. If those jobs become harder to get, I worry the prevailing wage will drop.

My company (private service) isn't at all worried nor am I. The bulk of the money making part of the biz is contracted transports with long term care facilities. The 3x weekly dialysis transport is our bread and butter. The emergency response part of the biz is subsidized by that division which makes it nice. However, if I were employed by a muni then I'd be worried. Emergency services always seem to be first on the fiscal chopping block. Of course, it never occurs to the city fathers/mothers that firing the redundant staff around the office (the head of a dept has an undersupervisor who has an assistant and they all have a secretary, etc) is a better way to cut the fat.

Interesting discussion, except that our regional Med Control protocols doesn't include the use of glucagon :? . They also don't allow RSI :roll:

Yup, most agencies' insurance requires you go through EVOC or something similar though. In private EMS (in Michigan where I work) your 'driving status' is determined by the insurance companies. Our company has people with valid state driver's licenses that due to their record cannot drive the ambulance. Off topic, but that makes for a craptastic 24 hr shift when your partner can't drive :roll: