HERBIE1

We have a hazardous profession, filled with potential health risks as well as opportunities for injury. I agree that suing for injuries sustained in the line of duty is wrong, but I'll play devils advocate here. What if the injury was sustained due to negligence and the injured party has no other recourse? What if that provider's benefits aren't so great, if they were living paycheck to paycheck and became mired in debt as a result of the time off work? Workers comp only covers so much.

As distasteful as it may be, the person may have no other recourse but to sue. Your first priority is to your family and if that's what you need to do for them, then you do it.

Hey all, Im an EMT-E from Va..yes Enhanced is a stupid level but meh.. ALS nonetheless...anyways good to be here hope to talk to you all more.

Welcome. Apparently you guys start training pretty young. (Your age says 10)

How much do you think they will appreciate the enormous bill for transport, rescusitation efforts, ED room, etc. etc. for what was clearly a doomed effort ? And as you are extrapolating, how much do you think the family of the dead patient across town that could have been saved if resources had not been expended on a hopeless case were not tied up working the hopeless case?

With that rationale, and the same reasons you cited, then why resuscitate anyone over the age of, say 75? After all, they probably only have a couple more good years left anyway.

Now we see a perfect example of why these arbitrary- and completely inaccurate- labels should be banned. Do you think people from Egypt, or those from a North African country, or even South Africa- call themselves African Americans? Of all people, they SHOULD have that title, if we are determined to use it.

Once again, be careful what questions you ask- you might not like the answers. Just like the Miss USA pageant- the poor woman was asked a question, she answered it, and was vilified for it.

Some do Do your research Check with Trace, Vandenberg, Med Ex, ATI, Bud's, Superior. All of Those are in the City in some sense, Kurtz, A-tec, Advanced, Alverno, Rescue 8 if it is still in business, First Care, Precise, Lifeline, and RMT are all mainly suburbs. It's been over three years since I have lived in Chicago, so some of these companies might have new names or merged etc. You have plenty of choices call around and good luck

SOme of those companies also hire for special functions, which would be part time- working at a horse race track, manning a first aid station in a big venue. There is also a company that soley staffs specials events- concert venues, privately run festivals first aid stations at museums, (some museums also hire directly)

Good luck.

We cannot refuse to transport anyone who requests service. Obviously, if they endanger the crew, the police become involved but we cannot unilaterally decide we won't take them.

Just an FYI-

EMTALA does involve prehospital in some ways. If a crew does not properly hand off a patient to an ER- IE properly or inadequately notify a triage nurse, we can be held liable and that is an EMTALA issue.

SafetyPAD. Whatever you use, make sure the field providers(users) have significant input in the process. Much of our software was designed by an MD who was familiar with the system, but not the day to day operations. It is NOT what I call user friendly. The program is only as good as the people who provide the data to the software people.

In my system- he would be worked- no question. The injuries listed were a deep skull lac, and he obviously had a bleed with the deviated gaze. That is NOT massive trauma. PEA is certainly dead, but depending on your system protocols and transport time, he should be worked. Would he stay dead- undoubtedly, but a closed head injury is not what I would consider enough trauma to justify withholding efforts.

Since bystanders said he had a pulse,(allegedly), go through the motions. Just because CPR was started however, does NOT mean it cannot be stopped- call medical control and explain the situation. I've seen CPR being performed on people with rigor so severe they rocked with each compression. I've also seen CPR performed on someone who was already beginning to decompose. Does that mean you cannot stop CPR under those circumstances?

Again, depending on local protocols, I know some systems do NOT work a traumatic arrest who is asystolic(considering the futility of these situations, it makes sense to me)- regardless of the severity of their injuries. With a PEA, I would say that goes into a grey area and again- I'd work 'em unless told otherwise.

Not everyone who wires those up is the sharpest knife in the drawer. We've had woods fires from fences, animals killed because one was leaning against a metal stall, and made contact with a wire at the same time. We used to touch them on a dare as kids. But I've seen some that would likely kill you, just by the damage it does to things touching it. Tree fires, barn fires, from the wires stapled to them loosely. Moves around, spark, poof.

Never saw one personally- I'm a city boy, but I still can see the potential for bad things happening. I would imagine the voltage would need to be pretty high in order to "dissuade" a large animal like a cow or horse from challenging it, so why would someone mess with it?

It actually demonstrated the properties of electricity, but how stupid are these people for participating in this "experiment"?

Braniacs, indeed.

LMAO

The point about not knowing what you don't know is HUGE. At any age, many times when we are starting out in this business, we do not know if we are being led down the wrong path by a preceptor or a mentor. The younger you are, the more difficult it is to tell the difference between proper instruction and a bum steer- you simply have no point of reference yet.

I am hopeful you get proper instruction and guidance- both on and off the job. The problem is, we get absorbed in this business and due to it;s nature, much of our social lives revolve around people who do what we do. At 17, you need a broader perspective on life than that.

Desire to help a new trainee succeed, rather than show how much you know.

Being open to different people's learning styles or just general work styles and letting them develop their own way, while still making sure they can get work done and multi-task (this is mainly for the head in clouds personalities).

Listens to questions and tries to understand where trainee is coming from, rather than just correcting them. Willing to put in that extra time. If he's having trouble mapping, re-telling him how to map doesn't help much, rather having him walk you through how he does it to find what he's doing wrong in his head.

Knows a lot not only about pre-hospital medicine, but about the company. Knows how to be a model employee, as well as a good healthcare provider.

Isn't too easy on them and expects a lot, but not so 'chill' that the new employee comes out mediocre.

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Good point about the organization. Navigating the politics of an organization, understanding how things work, how to get things done, how to be a good coworker, and your place in that organization. All as important as providing health care instruction.

They are two completely different types of running. A 15min mile can pretty much be walked. While doing the shuttle run takes more energy and more demanding on your body.

Agreed, but I was thinking about distance running in general. Compared to a 15 minute mile, no question, a shuttle run is far more demanding.

http://www.epocrates.com/index.html

Thanks. It's not often that I have the time(transport times are short) or need to get definitive info like this but it's good to know it's available when necessary.

What are some of the qualities you've noticed make good preceptors or FTOs (whatever you call them where you work)? Have you had an especially good or bad preceptor before? What was it about the experience that made it good or bad? What advice would you give to a new preceptor?

(btw I'm talking about both preceptors as those who train new paramedics, as well as those who train new employees)

Experience is number one for a preceptor, IMHO. Someone who is well respected by their peers, has a good educational background, a good skill set, patience, and training as a teacher would be a plus, but not necessary. Being able to select someone based on a consensus of fellow providers would be a good thing, if possible. Being able to listen is also vital. I've told every one of my students that I can also learn from them- new attitudes, a new way of looking at a problem, an alternate solution, etc. They usually look at me strangely, but I always tell them you are never too "old" or too "experienced" to learn. I also preface that comment by saying that there will also be times they need to listen and not immediately question- there will be time later for that.

The worst preceptors are the ones who let their personal issues cloud their teaching. Displaying a poor attitude or personal biases, exhibiting poor patient care, improper shortcuts, etc. We've all seen them, and wonder who let them become a teacher of new providers.

No offense to any Aussies here, but I'm thinking that the criminals down under aren't the sharpest knives in the drawer if all it takes is a picture to scare them off. LOL

I've decided to take the blame for everything that has gone wrong in the world since time immemorial. Feel free to blame me for the problems in your life!!!!

Thanks.

Well, I personally blame you for me never winning a big lottery payout.

Then again, I also think I need to play it to win...

One thing we always argued when it came to the bi-yearly eligibility test was, what's harder, quarter mile shuttle or a fifteen minute mile run?

It seemed like they alternated the two when the test was given. I did the shuttle. Running a certain distance, stop, pick up a object, and run it back the same distance equaling a quarter mile.

I too have ran a mile but not as a test. But I know guys that can do that at a fast pace and never break stride.

But I do have it on good authority that now some groups are testing two mile runs. I don't know about that. I've always been a sprinter and not a distance runner, when I ran.

Depends on your body type, I'm thinking. Long and lanky generally makes for a good distance runner. You don't see too many short, fireplug types running marathons. A shuttle run is also about endurance but it takes coordination and agility. Different stresses on different body parts.

Is this run a part of your job requirement?

We are all surrounded by the wonders of technology every day at work. Monitors, synthetically designed drugs, equipment, telemetry radios, even our apparatus are marvels of innovation. Having said that...

Has anyone ever used their PDA or web enabled cellphone during a call-(besides for contacting medical control)? Recently, we had an OD, and the person took an obscure medication- one that was new enough that I knew it was not in any reference material we had on board. I honestly forget what the drug was, but neither my partner or I had ever heard of it. We both thought it may be a new diabetic medication but we were wrong. I connected to the net via my phone, googled the name, and in a matter of moments, found out that is was some type of psych drug. Treatment was only supportive, and the call went without incident.

Later, we both laughed and were amazed at how cell phone technology could become such a valuable asset. Cell phones didn't even exist when we started our careers and now we were using them to help treat a patient.

Amazing...

I have no doubt someone can be qualified on paper to be an EMT, regardless of age. The problem is, maturity is a huge issue, and I question that someone at 17 is capable of handing the awesome responsibilities of medical care. Training, skills stations, and moulaged victims are also NOT the same thing as the real deal. I think that at some point in the future, more stringent universal guidelines on age are needed to protect providers as well the the public. I have seen doctors- especially from India where they can finish medical school much faster than here- who seem woefully unprepared to deal with the responsibilities they have and decisions they must make. Yes, there are always exceptions to rules, but I think a certain amount of life experiences(maturity) are necessary in order to be able to handle what may be asked of you every day. While most of the things we deal with are routine, what about those horrible calls? Mutilated children in a car wreck? Abused and neglected kids? Homicides? Difficult patients and family members?

Personally, I vividly recall when I was first "turned loose" and functioned as a brand new EMTB, ready to provide patient care. I was a college graduate, 23 years old, and had already been living on my own. I had great training- didactic and clinical, but this was going to be the real deal. I still felt overwhelmed for what I had to do, but having a good preceptor was critical in gaining confidence in my abilities. I simply cannot imagine having to face such a thing at age 17 or 18. At that age, most people- myself included- have no idea what they don't know. You feel invincible, you have all the answers and can handle anything, but realistically, I didn't even know what the real questions were yet. Was I mature at 17 or 18- yep. Worked, got nearly straight A's in school, but I was still a teenager, with all the trials and tribulations that entails.

Despite all this- I wish you luck in your new career. You may be the exception, but either way, I hope you have a mentor in the business and/or a trusted adult to help you through those inevitable difficult times- you will need them

No disagreement here from me Herb. I do think it's important to ensure that students know how to work the cot before you add any weight to it. I've done a lift with someone in class who started fumbling with the trigger (cot's fault, not theirs the thing ended up going for maintenance) but they lost their focus and rather than put it down almost tipped the thing over. This was a 4th semester student, imagine someone on the first day, with no grasp on their own physical abilities, no experience with how the stretcher works? That's really my issue, don't give them the weight until they know the equipment. It's not just their backs on the line it's their partners too. I had classmates I refused to lift with given their history of dropping the stairchair and failing every lift they'd done to that point.

I agree that an empty cot should be used until a person understands the basics on it's operation, but as soon as possible the point should be made that lifting- especially with the 2 man stretchers- is a HUGE part of the job. Once someone is familiar with it's operation, they should be made aware of how much weight they will be responsible for lifting. If they cannot do it in a controlled environment, on a level surface, with a static load, then a real lift, with a real, wiggling patient would be impossible for them.

For the first 20+ years of my career I used a 2 man cot and only in the last few years did I get a one and half man bed. I could have used this thing a LONG time ago- it's great.

I know this will upset the ladies, but I HATED working with women with that 2 man stretcher, especially since back then, too often we had no lifting help. Women and men lift differently, women simply do not have the same upper body strength. Yes, there are exceptions to that rule, but countless times, women I worked with were able to get the cot from off the ground, up to near the level of the rear of the ambo(essentially a dead lift), but that last movement- bringing it to the ambo floor and into the rig was tough for them. I was usually left to wrestle it in essentially on my own. That was a big reason my back is in the shape it's in today.

do we really need a bashing thread about politics??

But it's so fun!!!

Reread the initial post here and have one big gaping question: why the frig were students starting with near full weight first time out? In my program, first week, the stretcher, stair chair, even backboard were kept empty until we were practiced with coordinating our lifts, working the trigger mechanism, walking with another person. We then slowly added weight until at the end of first semester we had to lift with 150lb dummy, then 175 at midterm, 190 at 2nd semester end and finally 210lbs for third semester onward. A LOT of people can't lift anywhere close to the final weight safely at the beginning of the program. I think it's really unsafe to start students lifting that high a weight before they been trained on the equipment and have practiced. Sure many will be fine, but those that won't be are a huge potential liability for the school and instructor.

Good point. Maybe they use it as a method to weed people out? Stupid- maybe, but I also never had a gradual increase in the weight of the cot. I think it's a valid issue- the job is very physically demanding and that certainly needs to be addressed early on- for the sake of the rest of the class and the student. IMHO, the jump between 150lbs to 220 pounds isn't huge. If a person has trouble lifting 150 pounds, then lifting anyone with real weight is going to be a problem.

Think about it- a stretcher can easily weigh 40, 50, 60 lbs or more. Unless you limit your patients to pediatrics, how many of patients only weigh 90-110 pounds? Now add a backboard, maybe an O2 tank, a monitor, and I don't think 150 pounds is an accurate example of the physical demands of the job.

I would bet a large sum of cash that plane was full of Democratic bigshots. This is the equivalent of staying in the Lincoln Bedroom- a perk for being a party loyalist. Donors, lobbyists, political cronies- who knows. I simply refuse to believe that plane was empty.

Stupid- damn right. It costs a fortune for that plane just to spool up it's engines and to fly over NYC, with a fighter escort? Incredibly stupid.

recommended for state certification! Also, top of my class of 35! I still have the state written and practicals to go through, but with some luck and a little more practice, I could be certified by the end of next week! This is a shamelessly self serving post and I don't really have any questions, but if you have some advice for a brand new emt (hopefully), I'm all ears. I have a job lined up working summer concerts at a ski resort as an emt, and maybe doing a little bit of bike patrol. Super happy I worked really hard and I beat all those other jokers in my class!

Congrats! I echo the sentiment of continuing your education- even if it's it's just gen ed classes until you find something that interests you. It's ALWAYS good to have something to fall back on- just in case. Look at the threads on injuries and see how quickly things can change.

There are plenty of ways to use nearly any college degree in EMS- teaching, training, research, finances- even politics. It helps to set you up for hopefully a long and fruitful career.

It's also easy to become wrapped up in the business, and not see other possibilities for your future.

Keep up the good work!