emt217

Well, it'll be more urban based due to my locale. It will cover as many agencies as will allow me. You nailed it with the last couple lines though. It is meant to portray what happens behind the scenes I suppose. Just the physical, mental, emotional, spiritual, and financial toll it takes. My ultimate goal is to provide the viewer with what our lives are like. It will span months of footage, personal stories, spouse comments, etc.

Sorry, I shouldve explained better. I didn't mean to sound like I was trashing the other shows. I was merely trying to point out the type of view they use. It's more entertainment based. Granted, there are nuggets of real life in there, but my goal is to view us from the more human side. Lack of family time, strained relationships, missing all those things our children do in school, sports, etc. The long hours without sleep, meals, or even a shower. Adding more shifts just to make ends meet. That's my approach to it. I guess you would view it as us not burning the candle at both ends, but rather dunking it in diesel and setting the whole candle on fire. Again, apologies for the misrepresentation.

In mid-January, I and some of my co-workers are beginning production of an EMS documentary. After much discussion, we have a general idea of where we want to go with it, but I would also like to open it to ideas here. There have been the "action" side of it with the Discovery Health Channels "Paramedics", the less than flattering side, such as "Trauma", and the darker and, (IMHO) slightly warped view in "Bringing Out The Dead". We want to come from a more personal side, showing the long hours, time away from family, the long term stress effects, how most of us need to work ridiculous hours just to make a living, etc. I want to make absolutely sure that it doesn't portray our profession in a negative light. Therefore, I am asking for any and all constructive input. What would people like to see in such a documentary? What would you like to see portrayed in a different aspect? Any parallels to personal stories? I know this may seem a little odd, but I just feel that we, as a whole, are either misunderstood, negatively portrayed, or commercialized for theatrical purpose. I want people to see us for what we really are. Human.

Here are a few more that seem to help on occasion: Medical Calc - Nice calculators for various topics, ie: Labs, Parkland formula,etc. IV Calc - Rapid dose/drip rate/infusion rate Full Code Pro-Code logging

I'll be finishing medic class in 10 weeks, and am beginning to look for interesting, progressive areas to work in. Yes, I may be jumping the gun a bit, but I like to try and plan ahead, as well as gain all info I can before making any decision. I've looked in the Carolina's, and found a few interesting services. I'd love to move back to Florida, but I don't think there are many services that aren't fire based. So I'm turning to you guys. I read this site extensively, even if I don't post much (sometimes I don't feel intelligent enough to!) Any and all replies/suggestions welcome. I'm looking for a fairly progressive system where I can use what I've learned. And after pulling 8 years BLS duty in West Virginia, this isn't the place for me. I don't mind the occasional renal or physician run,as these patients are as needing of our services as anyone else, but I don't wanna be an ALS dialysis transport forever, if you know what I mean.

Well I'd like to start off by telling everyone how very much I appreciate all the input. I'll try to skim over some of the replies. As far as the time is concerned, I only worry about it with the mannequin due to Natl Reg time constraints. For an actual patient, I use the technique this absolutely wonderful preceptor I now have taught me. Hold my breath until I get the tube. She said "If the pt isn't breathing, neither are you." I got three intubations day before yesterday. My IV skills have DRASTICALLY improved. The ER I'm doing rotations in kept pushing me to use 20's and 22's. I started pushing 16's and 18's and have nailed every single one, so I'm quite happy about that. I lucked up in the past week or so since I first posted and got 2 awesome preceptors. They have a "no pressure" attitude, and combined with not having ParaGod syndrome, I learn a lot more. Both tell me that I'm the medic, they're just an EMT. They kinda force me to "teach" them, which vastly improved my performance. Sounds odd, but it's worked quite well. My confidence is up, and I'm starting to get into the "Paramedic mindset" as they like to call it. My ridetime preceptor told me that if I think and act like I'm a medic, I'll start to feel and perform like one. He was right. It surprised me how much I've improved in only two weeks, but I feel I need to thank all that threw out extra ideas. It helped more than you could imagine. Now......anyone wanna hold me hand and walk me through 12 lead?? We started cardiology this week, and while it does seem a bit daunting, I know I'll get it. Again, thank all of you so much for the advice. If all goes well, I'll be posting the "I PASSED!!" thread around the middle of December.

Well I guess you could say the Paramedic program I'm in is a "Medic Mill" of sorts, but it also holds a very high reputation in the area. It's only one year in length, but most if not all requirements are above and beyond national standards. And the setup, in my opinion, is much better than other local college programs. As an example, Pharmacology at two of the other colleges is a one semester course. My program teaches it the entire year. It's broken down based on what we are currently learning in other sections. If we are covering trauma, we cover medications based on MOI. In cardiology we cover cardiac drugs. Pulmonology we cover respiratory drugs, and so on. It helps to tie the medication into the problem, making it much easier to learn. We are also given a list of 40-50 medications a week to memorize. These are the most common prescribed medications, and we are to learn generic and trade names, as well as its primary indications and contraindications. As our instructor said "Sometimes, the patients drug list is the ONLY clue you have to the underlying condition." Sure, a lot of the drugs overlap, but the repetition makes it easier to learn. Also, in cardiology, most of the other colleges are instructing on 3-4 lead. Ours only covers 12 lead. We get tested multiple times per class day, and have skill check-offs on a 3-4 week basis. During some of my clinical rotations, I have worked alongside some of the students from the 2 year programs, and they seem lost. Now granted, I posted a question in the student section a couple days ago regarding some issues I'm having, but those are related to my being new to some of the procedures, not the program. This is the programs 4th year, and of the previous three rotations, there has been a 90% passage rate on the National on the first try. Yes, I know that only means you can pass a test, but the program isn't geared towards that. Our instructors aren't teaching how to pass an exam, but how to be a competent provider. We are constantly given scenario's in which we most diagnose, implement a treatment, and adjust based upon physiologic changes. We complete a run-form, and in some instances, are given a mock deposition from a local prosecutor. All in all, I'm very pleased with it. It's gained so much local and regional recognition that one of the universities will accept the programs hours, along with their own subsequent CCT-P program, and award an A.S. based on it. While i would have to agree that most one year progs aren't great, I was lucky to find one that really is all it's cracked up to be. Just my 2 cents.

I'll try that. I spoke to my instructor, and he told me it sounded like I wasn't placing enough pressure. He advised the same as you, to just imagine that I'm intubating the dummy. He said it takes as much pressure an a live patient as it does the dummy to visualize the cords, and that I'm not gonna do any damage so long as I use the technique we were taught, and that if the blade seemed too big for the mouth (Mac 3) then I just didn't have the mouth open enough. He chalked it up to being new, and nervous, and said it happens to most students first couple rounds. Thanks again for the advice. Would anyone else chime in?

Yes, it's only week 3 of clinicals. One thing I have noticed about my IV issue is the difference in angiocaths between the ER and the service I do ridetime with. The caths on the ambulance have about 1/16th of an inch between needle and cannula. The ER's is about 3/16ths. I wasn't advancing far enough before trying to canulate. Blew the vein everytime.

Long time lurker, occasional poster. Read this site ALOT, and have gathered numerous tidbits. My class started clinical rotations a couple weeks ago, and although it may sound stupid, I'm wondering if I'm putting too much pressure on myself. I'm not really good at IV's yet (blow about 30% of the time), and today I did my first OR rotation so I could get my intubations. I had 3 patients to intubate. The first one I did place correctly, but didnt advance far enough. When the cuff inflated, it popped it out of the cords. 2nd attempt was a good placement. 3rd attempt, the cords were angulated anteriorly, and I thought I'd gotten in, but it slipped of the posterior cords and went into the esophagus. I guess what I'm wondering is if I'm expecting more out of myself than I should be this early into clinicals. Did any of you guys/girls have a tough time at the start?? I'm doing really well in the classroom setting, as well as my assessments. It's the skills I'm not so hot at right now. Any comments or thoughts?

I really appreciate all the responses so far. I already figured the numbers would probably include benefit packaging, and maybe even so far as to include certain levels of tuition reimbursement. A bigger selling point to me is the actual in-hand income vs. cost of living. I know here in WV, I can buy a newer home for less than $65,000, but i'll also top, TOP, out at around $10.50 hr as a medic. $14-$15 if I have my State CCT Cert. I;ve been leaning strongly towards Maryland, Texas, Louisiana (oil rig perhaps?) and NC, with a real interest in Wake Co. EMS. I've been doing some research on Wake Co., and while it's just an opinion, they seem to have a nice balance of pay, benefits, and aggressive protocols. My brother lives in Asheboro, which is only a couple hours away, but he tells me I can find affordable living halfway between him and the Raleigh/RTP area. I'd like to hear from some of you that may work/ have worked in these areas. I don't mean to keep throwing so much out, but I'm pushing 37, so I wanna make the most effective move I can when I do. I want to get alot of the homework done ahead of time. I've seen a few friends that went from EMTB to EMTP, hit the road, and come back 6 months later because they didn't take the time to ask.

Thank you sir, I appreciate the response. Actually, I dont plan on going fire route. I just know most places seem to be going fire based. I've been an EMTB for 7 years or so, heavy 911 volume. I'm hoping to go somewhere that has separate fire/EMS.

Thank you, I would appreciate it! I currently live in WV, and would love to relocate. We have a very conservative system here, with protocols that look like they came from the early 80's. Sure, I want to make a better living, but I also want to go where I can use what I've learned.

Top 10 paying states for Paramedics Looking for places to relocate after I finish school. Any of these places even come close, or is this Fire based?

Actually, this helps quite a lot! We are taking a full A&P course in parallel, and to be honest, I'm jumping ahead a little. I just want this sooooo bad that i'm willing to put in as much time as it takes to understand all the concepts. Our instructor went through the atomic and molecular levels rather quick. Most of the other students just memorize and move on. Maybe I'm odd, but i want to understand what's going on. I'm not a memory person. If I can see how it works, and comprehend the mechanics involved, it sticks with me. Again, thanks CH, I appreciate it! edited to add: I do have an understanding of the pH scale, and the hydrogen/hydroxide difference. The equations were getting me. Been around 18 yrs since i had algebra/calculus, so i'm a little rusty. Gonna do a quick math review.

Any good reviews, animations, etc. For some reason, I just can't seem to get this in my head. I'm pretty sure of 2 things: 1) excessive CO2 retention is respiratory acidosis 2) excess release of CO2 is respiratory alkalosis I've gone over it a million times, it just isnt sinking in. i don't wanna memorize it, i want to LEARN it. ANY help would be much much appreciated

I'm concentrating on it one step at a time. We were issued the Brady 6 book set, Pharmacology, A&P and workbook, Basic and Advanced Arrythmias, and as a bonus : Medical Terminology. Our 4 instructors thought the latter would help, and I agree. I was just wondering if anyone had any coping techniques for when you get that "overwhelmed" feeling. I know it will be a tough road, working full time, clinicals, class, and study time, but I know it will be worth it. I've read TONS of information on this board, and feel confident that I could ask questions. Just thought I'd see who had any tips.

Guess "personal" was a bit much. I love this field way too much. After my second little one came along, finances just got too tight, and the irrational amount of hours was getting to me (I was a regional BLS stupervisor). Southern WV is far from being a place to earn a good living, so I hit the road in search of something more profitable. Having let my NREMT cert expire (not required here in WV), i just went with what I knew. I woulda LOVED to run EMS there, but with the fire base, it wasn't feasible. My wife still wasn't physically up to working, and I have a severe phobia of daycare centers. It was a personal choice to wait till now to take a medic course. I wanted to be 100% comfortable in all my skills as an EMT before taking the next step. I've seen too many EMT's move up the food chain too soon, and it ALWAYS ends bad. Either burnout, poor confidence, or substandard care. I needed to be comfortable with my skills before moving on. Again, FL is not the only place for me. I haven't lived alot of places, so I was working from that. My brother lives in Asheboro NC, and has told me more than once there seems to be a need for providers. Been looking at Wake Co EMS online today. Looks like the kind of place I'd be interested in. And, as always, thanks for all the input. I enjoy the constructive criticism.

As far as location, I'm not picky. Granted, south florida is nice, but I guess the hillbilly in me can't adjust to the culture. I was more or less going on where I had lived. I've also been looking into a few other states as well. I guess what I really want is to find a progressive system to work in. Maybe I'm wrong, but I don't wanna get my Medic card and all the alphabet soup certs to boot, and then forget most of the skills I've learned because I work for a service that does 300-350 calls a month. I know I may be jumping the gun, but I love this field too much to sit around and get rusty before my first re-cert. Any onther state suggestions would be greatly appreciated. I know I can get info from websites, but I like to hear from individuals who live/lived in certain areas. Word of mouth is much better in my opinion.

I lived in the Plantation/Ft. Lauderdale area for a few months in early 2007, then moved to Naples. I had taken some time off from EMS and had gone back into Fire Alarm/Security systems. Just needed a breather for personal reasons. I moved back to West Virginia in early 2008 due to parents health failing. I am now back into EMS and start Paramedic class next week. From the short time I lived there, I know most EMS is Fire based, and I'm not sure about other providers, ie: AMR. Do the non fire based EMS run transport only, or are they on the 911 system as well? Is the pay decent? Opportunity for overtime? (I currently work 100+ hours a week, I kid you not!) I know it's alot to ask, but I don't wanna move back just to run dialysis/appts. I also wanna make enough to live. I could get my FF 1 and 2 here, but to be honest, firefighting isn't for me. Any info appreciated.

Sorry, should have explained better. I waited around for 20 minutes AFTER reaching the ER. Once the medic saw the rythyms, we hit the road wide open. As an update, ran into the same medic today. I respect him now. He apologized for the attitude, and said i was proving myself as a good provider by following my gut.

While I'm not an ALS provider (yet!), I agree 1,000%. Too often I find myself at the "demands" of the pt. ie: I wanna go HERE instead of there! I need help, I have lockjaw (stated while eating an Otis Spunkmeyer Giant Chocolate muffin) Or my personal favorite- I haven't feel good for about two weeks. I have a sore throat and runny nose. (when I asked him if it was worse now than the last 14 days, his reply was, and I quote) "I've missed 4 days from work. If I call in I'll get fired. I figure if my girlfriend calls in and tells them I'm so sick I had to go to the hospital by ambulance, I won't lose my job! I firmly believe that the AMA, NREMT, etc., should legally recognize "dumbass" as a C/C. On a more serious note, had one of those "poor providers" back me up on a pt with CHF so severe he was on the verge of flash edema. Now my protocols state no Albuterol if: Pt over 45, PMHx HD,HTN,MI. HR >130. This guy has weeping edema lower extremities. If you put your scope on and dropped the bell into a flushing toilet, there are his lung sounds. My "backup" gave me down the road in front of the pt and family for not giving neb Rx! More often than not, I do my damndest to diagnose, not just "tech". I firmly believe you can't treat without an initial diagnosis. If we tech and don't diagnose, why are we even here?

Thanks. My concern was either A) He was on the verge of a CVA, or correct me if I'm wrong, but with BP increase and HR decrease, I figured something neurological may be taking place. Granted, not alot a medic could've done since WV protocols don't include thrombolytics, but I woulda felt more comfortable with a second set of hands in the back. 90+% of our calls are 45-60 minutes to an ED. All the pt kept telling me was "I just don't feel right". From past experiences, I ALWAYS listen when I hear that!!

Long time lurker, new poster. I want to start by saying how much I have learned from all the reading I've done here! You guys are MUCH more intelligent than the boneheads I work around., as well as much more profession oriented. I start Paramedic class in 2 weeks, and am looking forward to leaving the area IMMEDIATELY after. On to the subject. I've been an EMT-B for close to 7 years now. Never was much for gut feelings as 99.9% of our call volume revolves around COPD, CHF, ESRD, HTN, or DM. We have a fair amount of ATV accidents, but this centers around med calls. Last night I had a 72 y/o male, wife called 911 stating decreased LOC, possible hypoglycemia. While enroute, 911 informs us pt is more A+O after eating cookies. Upon arrival, pt presents with no distress. No CP,SOB,N/V. initial BS is 65. Wife also states slurred speech. I run a quick neuro assessment. No lateral drift, no facial droop, + PMS all extremities. I go ahead with 15g oral glucose. after 8-10 minutes, BS is up to 95. Pt states he feels better, but is experiencing numbness to L side of face, radiating down L arm. To shorten up, all vitals WNL, BS holds at 95. Pt has PMHx of DM, HTN, TIA x1. Transport to closest ER is 40-45 minutes. As I'm re-assessing, something just keeps nagging at me. I opt for ALS assist. Medcom concurs, and I meet up about fifteen minutes from ER. Monitor shows PAC's, BP slowly rising, HR falling. Waited around for 20 minutes or so, but finally had to run, so I'm unsure of what happened. Now, all that for this: Anyone ever get that "nagging" feeling something isn't right? The Medic wasn't extremely happy about coming out at 0230, as nothing major showed up. Still, I can't help but feel something just wasn't quite right. I feel I was well within my right to call for ALS, but now I'm begining to question it. Any similar experiences? Again, wonderful forum with lots of knowledge to share! Hope It's ok to pose questions on occasion while I spend the next year in school.