Asclepius

The American Heart Association had not published any position regarding this. Our current recommendations remain in effect to do compressions until the shock is ready to be delivered and to clear the patient prior to the release of energy.

Regards,

ECC Programs

American Heart Association

7272 Greenville Avenue

Dallas, TX 75231

So who watched House tonight? I was seriously peeved when he looked at the Paramedic and told him to start an IV in the patients tibia. The Paramedic gave a bland stare and then House made a comment about how they don't teach that in EMT school. First of all, that was deeply offensive to our profession. Secondly, IOs are most certainly taught in Paramedic training around the nation. The mere fact that the Paramedic had to step away from the patient and ask House what to do was insulting. Why does every show that has an EMT in it have to make us look like a bunch of inept fools who can't do a professional job on our best days?

House is one of my favorite shows, but I was ticked tonight.

I read, with great interest, the article in this months JEMS concerning retraining rescuers to keep their hands on the patient during biphasic defibrillation. I was intrigued, but not convinced that it is entirely safe, so I emailed Zoll to inquire about the safety. I also Googled to see if there were any articles that spoke to the subject. Below is what I discovered. What do the rest of you know about this? Anyone else hesitant to keep their hands ON the patient DURING defibrillation?

I wrote to Zoll and asked them about the safety of keeping your hand on a patient during defibrillation. They responded that you should NEVER leave your hands on a patient during biphasic or monophasic defibrillation, because the rescuer could receive the shock themselves. That being said, I did look for scholarly articles that supported the claim that hands on defibrillation is safe for biphasic defibrillation. I would be interested in seeing some of the science behind this article. I wrote the AHA for their comment and have not received a response. What follows is the responses I got from Zoll and the link to one scholarly article that I found.

"Always stand clear of victim when delivering a shock. Defibrillation energy delivered to the victim may be conducted through the victim's body and cause a lethal shock to those touching the victim."

I responded for clarification and received the following response.

"ZOLL Medical does advise on how to train EMS personnel. ZOLL Medical can advise that EMS personnel should always stand clear of victim when delivering a shock. Defibrillation energy delivered to the victim may be conducted through the victim's body and cause a lethal shock to those touching the victim."

Then I found this article online: http://circ.ahajourn...tent/short/C...

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If they can't afford a cab, I seriously doubt they can afford an ambulance ride.

In my experience, many times they can afford the cab and/or they may even have an operating vehicle in their driveway, but they know they're not going to have to pay the ambulance bill, so they call us and like idiots, we keep taking them.

I,too, worry about the potential can of worms this could unleash...but we've got to stop GIVING away our services to non-emergencies...so, who has other suggestions?

I just sent Kotex an email requesting information about this for EMS purposes. We'll see what kind of response I receive. I'll post it here, if I get one.

Speaking as having served in both career, in the beginning, and then mostly voluntary, I've never met anyone either working in or volunteering in EMS, that didn't have a passion for it. Sure, some are a little more into doing their personal best, but they all had a strong passion for it. As far as education, EMT's and First Responders. The highest being EMT, even when I was paid, the training is the same. Either way, you're the taking the same class, the same Con-Ed. However, I had more time with the patient, as a volunteer, because my primary function as a career EMT, was to drive.

I know many people who volunteer mostly because there is a need in their community. And while you're correct, the initial training is the same, many volunteer's do not do as frequent as training or get some of the additional certifications that working for a paid service would provide. I think that if you were to do a comparative study on the certifications paid staff have compared to the certifications volunteers have, you'd see the point I'm trying to make. I'm not saying anything to disparage the volunteers, I just think paid services tend to invest more into the education of their staff than volunteer services can afford to.

Wow.. I had more to say, but my allergy pills have me feeling like I'm hanging upside down... So... anyhoo.

I hope you feel better soon.

So you are saying vollys are holding EMS back? Because if the America you are talking about is the USA you are making a tongue and cheek remark as we all know the USA EMS is so far behind the times. It is a laughing stock to the rest of the developed nations and even many underdeveloped nations.

Not at all. I'm saying without volunteer's the EMS system we enjoy would be even farther behind than you seem to think it is.

This is as absurd as claiming you're too fat and that the IV attempt is cruel. If that person was having a heart attack and they tried multiple times to start the IV for the meds and the patient was saved then that would be okay. If you have to be stuck, however, multiple times to be executed then it is cruel. Come on, you're being executed because you showed no mercy for your victim(s). Frankly, I think that executions should happen more frequently for more types of crimes and I don't really care how cruel and/or inhumane the process is. Violently rape someone...death. Molest a child....death. Torture a civilian....death. The list goes on and on.

Volunteer Departments are the backbone of EMS in America. The problem with Volunteer's is that they're volunteers. They're not required to participate in all of the training that a typical career EMS provider goes through. They also don't run the call volume that paid services do. EMS is not typically their passion or career choice, but they do it because if they didn't, who else would? As a state regulator, I see many different kinds of agencies. I see good and bad volunteer agencies and I see good and bad paid agencies. Volunteer's most generally do the best they can with the resources they have. Sometimes they knock it out of the park and other times they do just enough to get by. I can say that of some paid agencies.

Do the best you can to thank them for their valuable service and encourage them to improve in areas of weakness. Without volunteers EMS would not be the success it is in America today.

A SOLDIER underwent a five-hour brain op to remove a high-explosive bullet - which could have blown his head off at any moment. Army surgeons donned BODY ARMOUR after the Afghan man was rushed in following a bomb blast.

Read more: http://www.thesun.co.uk/sol/homepage/news/campaigns/our_boys/2925205/Docs-pull-explosive-Taliban-bullet-out-of-soldiers-head.html#ixzz0kd2oGnOs

In other words, what would be my best course of action be in becoming an EMT? Would I need to become Professional CPR certified first or will I receive this training through school?

Welcome! Tis a noble profession that you've chosen to pursue.

You will need to become American Heart Association CPR certified, but many of the EMT programs include that in their curriculum. Not all do, but many do. So wait until you find a program. It can't hurt you to take an anatomy and physiology class. As you progress in levels of training, each level will teach you more about A&P, but I have found -having been an EMT-Basic, EMT-Intermediate and now an EMT-Paramedic - that none of the EMT level A&P classes are as in depth as an acutal college level A&P class.

Is it possible to self teach EMT principles and take the certification test on your own?

I always recommend becoming Nationally Registered as an EMT at any level. Most states require NREMT for reciprocity and initial licensing. At any rate, the answering to your question is no. You must attend an approved EMT program, complete the clinical and field internship, take a written and a practical examination to challenge any level of EMT test. For Indiana, if you go here, it will help you locate programs in the Indy area. Wishard has an ambulance service and if you contact their EMS educator, I am sure they will be happy to help you find a great class in the Indy area as well.

I live and work outside of Indiana, but I was raised near Ft. Wayne. If I can be anymore help to you please let me know.

Your fellow Hoosier!

http://www.stvincent.org/education/ems/emtcert.htm

http://education-portal.com/emt_certification_indiana.html

http://degreedirectory.org/articles/EMT_Classes_in_Indiana_Which_Indiana_Schools_Offer_EMT_Certification_and_Training.html

Just a few I found with a quick Google search.

The NBC series "Trauma" was lambasted by the emergency medical community when it launched in the fall for factual mistakes and an inaccurate portrayal of that world.

Indeed, more than a few said it was a weak imitation of "Emergency!," the 1972 series with Randolph Mantooth and Kevin Tighe as California paramedics that many held up as the best portrayal of EMS life.

Executive producer Dario Scardapane is well aware of the comparisons.

"I think our DNA and 'Emergency's' DNA are very, very close, and I was at first really, really shocked by the paramedic backlash," Scardapane said yesterday. "And in a sick way, I kinda got into it to find a way to learn how to do the show better."

Full Article

I, for one, think that it would serve us well to go through a little self-defense training. Maybe something like what police academy students go through. We also should be allowed to carry pepper spray or a taser. I worked, for a period of time, in one of the worst parts of a major metropolitan area. The system was set up for police to respond with us on almost all calls, but several times we were instructed by our dispatchers to advise if PD was needed upon our arrival. Well, if PD is needed, after our arrival is not the ideal time. I've been fortunate in all my years of EMS, to not have had to get seriously ugly with a patient or their family/friends. It only takes that one time, though. Having a knowledge of how to react in self-defense can go a long way in giving a person a skill set to defend themselves, provide self-confidence, and to protecting the patient should you have to defend yourself.

As for learning something once that you'll never remember...I have to disagree here. We learn things throughout life that we may only be exposed to once in awhile. How many time does a provider do a trach in the field. Sure, it happens, but realistically, how often? Still, they teach us so that in that one time we have a knowledge of it. I'm just saying...an initial class with an annual refresher would probably be sufficient in providing EMS a base for defending themselves.

I wanna be careful here to stress that we should always remember that violence is NOT our job. We should defer to law enforcement whenever possible, but sometimes, law enforcement is not there.

Have a great day guys.

It's my opinion that the spirit of this discussion has diverged from what was originally intended. It is no longer a cool-level-headed conversation between professions and emotions are running high on all fronts.

Let's all just take a deep breath and see this forum for what it is, an internet forum. Is it really worth getting your BP elevated to debate with anonymous users? Wouldn't your efforts (on both sides of the issue) be better served taking action (non-violent of course) to express your views. There seems to be a lot of talk lately, but very little action to do something to alter this course of history.

I'm very actively involved in politics. I'm cool-headed. I still think this is a calm discussion. I just take offense to being told that anything expressed to demonstrate the level of the anger the American people are experiencing as "infantile." This is a very serious matter on so many different levels and requires our full attention. The POTUS was giving a speech today and making fun of all of us who recognize the threat this bill and the manner in which it was passed poses to every single American. It was deeply immature on his part and just continues to rub salt into the deep wounds they've already caused. It's disgusting. He's disgusting.

Tom is right, just because you don't like the bill that was passed does not mean go and throw actual rocks and that persons office or even send mail with baby powder in it. What that does mean is that in November when some of those ppl who voted for the bill are up for re-election you vote them out of office. Like Glenn Beck said in one of his shows this week "Game On Progressives, we will see you at the polls this November." So don't stoop to the level of actually throwing stuff or sending death threats cause if you do then your only proving that the left is right. that the TEA Party goers and 9/12ers are nothing than a bunch of vigilanties out for revenge just cause there representative did not vote how they want. Ghandi once said (and forgive me if I misquote) "Use truth as your anvil, and peace as your hammer." That is what you do, you hold to your beliefs and do so in a peaceful way.

Hey, I'm not saying I condone the violence. I'm saying that I am angry enough, and I rarely ever get angry, that I can understand it.

You know what? I am damn sick of all the exaggeration and violent talk! DAMN SICK OF IT! More profanity would be included if this were not an internet forum. But seriously people? I am ashamed that some of us are now cheering on death threats? Saying Obama has now ruined the whole country? Revolution is the only answer?

Excellent, then you're as angry as most of the rest of the country is. Revolution is not the ONLY answer, but they're not giving us many alternatives. There is no exaggeration in any of this. This is serious and perilous times for us. Obama is the worst president in American history. Congress has the worst approval ratings in American history since polls started being recorded. This isn't a handful of fanatics that are angry...this is the OVERWHELMING majority.

I didn't see anyone b1tching like this when the federal gov't saw its largest expansion ever under Bush. Now some of you sound like chicken little with talk of how "the sky is falling!"

Bush didn't actively work to socialize America. Besides...we're not talking about Bush anymore. Bush's time has come and gone. We can't undo anything about the Bush presidency. He needs to stop being everyone's answer to what Obama is doing to destroy this nation.

I don't necessarily agree with Obama's bill or many elements of his presidency, but as an EMS professional, citizen, and human being, I know how to appropriately express my views and push for change

.

I think we all do too Funky....the problem is that we're under a regime right now. We have a government that has gone rogue and is acting contrary to the will of the people. We're being violated.

I am disgusted to hear some of the talk on here. You need to realize there are two sides to every issue, maybe try to look at the other side of things, or the positive in this very bill.

Maybe you need to more fully read the posts in this thread. We've all said there are a couple of things in this that don't sound bad. I like that insurance companies will not be able to hold a pre-existing condition against someone. That part of it is deeply overshadowed, however, by the rest of this terrible bill.

I DO think there needs to be HEALTHY debate about the economic implications and things I don't personally care for such as cuts in care for senior citizens, but come on people, lets grow up, clean up our act, and stop these INFANTILE EXPLANATIONS of complex issues.

I'm not cleaning up anything. This government has gone hostile towards the people. I'm advocating the removal of this governing body. I'd prefer it not happen by means of anything violent, but I guess that will be up to them. Violence is rarely ever the answer to anything in life. But sometimes people have to defend themselves, their principles and values. This government has nobody but themselves to blame for the threats they're receiving. They chose to arrogantly blow off the masses.

I do hope I am misinterpreting your posting.

I don't condone acts of violence, but I'm so frustrated that it is easy to celebrate this. Gotta do something to make these idiots actually represent us and not their own special interests. It was times like this that started the revolutionary war and frankly I think it's time to revolt. What do these guys expect when they act in direct defiance of the will of the people that they're supposed to be representing? The majority spoke in overwhelming numbers and they just flipped us all the bird. I've never been so angry in politics in my whole life and it's going to get worse. Next their going to give amnesty to illegal aliens and take over the banking systems...we HAVE to stop this crap!

By the way, Obama has done more damage to this country in one year then Bush did in all his tenure. And, Bush is no longer in power so it's time to stop blaming him. I was no fan of Bush, but Obama is destroying the American way of life.

A teenage boy playing a video game at an Internet café in China was stabbed with a 10-inch knife that went clear through his skull -- and survived with little noticeable damage, according to a report. Xiao Wei, 16, who was attacked in a dispute over the video game he was playing, was able to walk into the emergency room entrance of Jillin University with the knife still lodged in his head, the Daily Mail reported.

The knife, which had been thrust into his left temple, had three-quarters of an inch sticking out of the right side of his head.

Article

These types of things never cease to amaze me. I'm amazed first because someone could get so angry about a video game that they'd stab someone in the head. I'm also amazed that his guy walked into the ED and is going to have nearly no symptoms from this attack.

However, if your house burns down the fire department will come and put it out free of charge, the police don't send you a bill for helping you out if you need it, most local libraries are free, you don't have to pay to get US mail and so on and so on .... all of these things are regardless of income or how much you have "put into" the pot.

Newsflash...Fire Departments don't do their work for free. We pay for their services with our tax dollars. Despite paying for it with our tax dollars, most bill your home insurance and some bill you directly. Nothing is free...not police, not libraries, not the postal service...nothing. We pay for all of that. In fact, we pay for the services that other people do not pay for with our taxes. Those of us who pay taxes anyway. The government doesn't pay for your homeowners insurance. They don't pay for your auto insurance. Health insurance is not a right! What the heck makes you think (not you specifically, but anyone) that you have the right to health insurance or welfare or any entitlement. Nobody has a right to that stuff. It's that stuff that has got us to the point where so many people are without the means to care for themselves. What incentive do people have to go out and earn their own way? Why should they get off their butts and do anything for themselves when the government will do it all for them. A small percentage of people who receive government assistance actually really need it. We've bred whole generations of families who know nothing else but welfare and medicaid. They have no ambition to educate themselves, learn a trade or seek employment.

With the understanding that we are talking different states' protocols, regulations, and laws (I'm in NY), it translates much as follows (wording is mine, not the official stuff):

It is my presumption that this runs from volunteer agency "in-house" certified First Responders, to State DoH (department of health) Certified First Responders, EMTs, and Paramedics

I brought my own chair, but do you have any low or no-fat "butter" for that popcorn?

I'm pretty sure that's what I said.

My question is this though, what are the republicans willing to do to reduce the number of uninsured americans?

Government hand-outs is not the answer. Everyone has a sad story and I sympathize with yours. Forcing American's to foot the bill for your problems doesn't hardly seem fair to me. Most American's are charitable almost to a flaw, but when you force us to give...charity goes right out the door. I support making it illegal to deny someone coverage because of pre-existing conditions. I support cost caps. I support tort reform (which is where huge health care savings could be found). I don't support this massive tax bill veiled as health care reform. I don't support our lawmakers overriding the will of the majority, just to save the face of the president. Ramming through a bad bill that nobody wants and at the very least that everyone thinks should have been scrapped and started over is wrong and it is costing us our freedom and will worsen this economy to the n'th degree.

Well, since the vox populi here so far seems to pretty negative about the pending Healthcare reforms then let me re-adress the balance:

I think that it's a travesty that one of the world's richest and powerful countries has waited so long to adopt decent healthcare for all, regardless od socio-economic status.

Shame on you all for opposing this bill. And yes, I'm an outsider. An outsider that pays 52% income-tax to benefit from one of the world's most developed social security systems. No, we are not going to hell in a handcart from all the those free-loading parasites costing us a fortune. I live in a prosperous, caring country.

No-one in the developed world such need to worry about a basic right such as decent healthcare.

You want a strong opinion, you got it!

WM

You're missing the point here. The point is they defied the will of the people; the overwhelmingly against this bill people. But yes, this bill is terrible for this bill. No one disagrees reform is necessary, but not this bill. Not this bill, in this economy.

Just for the record I am not cert'd as I said but I do have training as an EMT-B and as such I am still covered by the Good Samaritan Law

Actually, technically, you're covered by Good Sam laws regardless of whether or not your are licensed or certified in anything. If you're working as an EMT-Basic on duty and you render care, you are not protected by the Good Sam Laws. Good Sam Laws are meant to protect off-duty personnel and lay people.

I no longer have to live in fear that an ER visit or doctors visit won't be covered because of a condition beyond my control.

No, now you just have to live in fear of the federal government and the rationing that will certainly follow. Now you have to worry about the huge tax and fee increases that are absolutely going to have to take place for this to have any chance of being funded. Then you have to worry about whether or not there will be a doctor to see you, since now there will be huge shortages. This bill, did nothing for American's except complicate everything and make health care worse! <BR><BR>Sorry, I'm new to this place, but I have strong opinions. The vote last night was the worst day in American History. It's the beginning of the end of America as we know it, unless we all do something to stop it!