Dustdevil

It's kind of like chemotherapy. It can be good for you, but it can also kill you. Timing is everything, as well as your physical condition. It's not the flush itself that is most potentially harmful. It's the potential of that unconsciousness-causing flush taking place while you are driving, or participating in other critical activities, that is dangerous. Secondarily, physicians or medics mistakenly treating the flush as anaphylaxis (as it very closely mimics) can be fatal.

Lemme see: NYC Health and Hospitals Corporation EMS from 1985 to 1996, that was 11 years, then the merger, and FDNY EMS Command from 1996 to 2010, that was 14 years. Leave us not forget Peninsula Volunteer Ambulance Corps from 1973 to 1996, which was 23 years...

I was talking specifically about America.

Actually, hospital based medic jobs are extremely rare over there, and usually administrative. Most commonly, the Dyncorps medics work clinically, treating sniffles and headaches among the civilian contractor population on base. You might run an ambulance from the clinic too. Dyncorp also provides field medics for EOD and poppy eradication teams, where they spend a lot of time outside the wire in harms way. Dyncorp should have informed you specifically what the position you were offered entails. The experience varies greatly from assignment to assignment.

Great info from usalsfyre, although I'm not sure I agree that MedStar is building a better reputation. I sure haven't seen it. And the city won't allow it, no matter how hard MedStar tries. But MedStar is indeed probably your best shot at an EMS job in DFW. The schools in this area are cranking out hundreds more medics every year than there are jobs for. The only reason that any of them can ever get a job is because of the high turnover of all the services. Very few people stay with an employer more than a couple of years maximum. And MedStar has a reputation for intentionally running senior employees off, rather than allow them to stay long enough to earn a raise or retire.

Arlington EMS (managed by AMR) indeed pays squat, and is overworked by System Status Management, just like MedStar. But somehow they manage to have relatively stable turnover. Nice equipment. But they are jerked around pretty badly by the firemonkeys, who use AMR as their whipping boys and scapegoats. There's a good relationship among the medics and firemen in the field, but the problem is bad at the management level. Like everywhere these days, the fire chief steals EMS funds for his own budget, then cries like a little bitch about how there aren't enough ambulances. Real genius, he is.

Wise County is county-wide third service and mostly rural. Not as good as they were when they were hospital based, but decent, if political. Only 3 or 4 units, so not a lot of opportunities there. And it's an hour from Fort Worth.

Parker County is also 4-unit county-wide third service, administrated by the hospital. Probably the best service in the area, with good pay. They have a VERY low turnover though since it's such a good gig. They hire medics only, and usually only very experienced ones. You might get lucky and land a part-time gig there.

Johnson County is countywide private service called CareFlite ground. Not impressed. Again, they were a lot better in the hospital based days. Pay is ugh, and as already mentioned, you pretty much only get there by first paying dues as a horizontal taxi driver in Dallas first.

Ellis County is countywide service run by East Texas Medical Centre EMS out of Tyler. I don't know a lot about them, good or bad, even though they're just 20 minutes from me.

Hood County is what Wise County used to be. Nice countywide public service with just a couple or three units. And it too is an hour from FW.

All of those rural services actually provide a very good experience. Don't fall into the trap of believing that only the big city boys get good experience. The rurals here stay busy and run a much higher percentage of serious patients than their counterparts in Dallas, Fort Worth, and Arlington.

Pretty much everything else in the area, with very few exceptions, are fire-based, dual-duty.

Why are you moving to DFW? I ask because, if you are doing so strictly because you think the job market is good here, you are seriously mistaken, so you might reconsider that.

I didn't know there was a movie. I need to check it out.

Dr. K was a good man. Ciao, Bro.

Oh man! I really hate to hear this. At least you have a little pre-warning, but that is no consolation.

I don't know what to say besides I hope the best for you, my friend.

I have to admit my first thought was the same as AK... the same partner for four years? What are the odds of that happening?

Even less likely than having the same employer for four years!

Caffeine is not the only problem with energy drinks. Niacin can cause some serious problems for many of us, and you won't know until it's too late. And even then, it'll most likely get misdiagnosed. We had an epic scenario thread here a few years back about the niacin flush, but unfortunately it disappeared, as too many threads here seem to do. Too bad, as it was very educational, and illustrated how easily it is dangerously misdiagnosed, even by physicians.

When deployed with the Marines, I ran into this problem quite a bit. I love the taste of Red Bull (Rockstar smells like vomit), but I am very careful to limit my consumption of it. The only thing worse than passing out from a niacin flush while caring for a patient is to do it while driving!

Here we go, the forum regulars crucifying a new person who comes to post here. Don't let a lot of these people get you down. It is a cult.

Are you retarded? To the very last person, everyone who gave an opinion here said they thought he did fine. Do you complain about blowjobs too?

Going into the practicals, I knew that I could end up with either a trauma patient or a medical patient, so I had to be prepared for anything...

Just be glad your school doesn't give you psych patients. Now that's a great way to cull the heard!

Congrats, Bro!

Students will become employees. Are we not supposed to set them up for successful careers in the field?

"The field" is not homogenous. Not all students will become employees. In fact, most will not, and never had any intention of doing so. EMS is a very big field, encompassing a lot of diverse job opportunities. Of those who do become "employees", many will be in jobs not requiring a level of fitness anywhere near what you are talking about. That is up to the employer to determine, not me as an educator. I'm not a gym teacher.

Before responding, I'd be curious to see what kinds of questions you'd be asking since many will come to you without any medical training whatsoever. Are you thinking basic math, grammar, spelling reading and comprehension skills?

Yes, there are several different types of pre-tests, with varying goals, so it would be helpful to know more specifically what we are talking about.

There are general aptitude tests, that test the candidate's potential for academic success. I like these. A lot of applicants simply do not have the potential to amount to anything, and it would be nice to know this ahead of time.

There are pre-tests, like given in ACLS, where the questions are the same as the post test, simply used to quantify the learning done in the course. I don't see any significant value to this in the pre-EMT-B setting. After all, it's an entry level course, not con-ed.

And there are pre-tests that are given to determine how much prerequisite study has been done by the student in preparation. I like these and use them. Students are required to have an understanding of A&P and medical terminology before enrolment. This type of pre-test assures that they have made that serious commitment to success, and are ready to begin intelligently comprehending medical concepts.

Why can't we expand on the topic?

Because forum rules prohibit it.

http://www.emtcity.com/index.php?app=forums&module=extras&section=boardrules

Do not hijack topics. Discussions should remain focused on the original poster's intended topic. If a separate topic or concern arises during the course of discussion, post that topic or concern in a new topic rather than sidetracking the original discussion.

I agree, that from the limited information we have here, it doesn't sound like your assessment was off-track at all. If a patient is conscious, breathing, and vocalising, your ABCs are done. No need to go through any pointless steps to satisfy any checklist in order to determine that. Assuming that immobilisation was actually warranted (which it sounds like it was), then you were absolutely on the right track to go straight to it.

Not sure why the other tech felt like s/he needed to take over. Did you ask him/her? It's possible that s/he simply sensed your discomfort and stepped in. But it also sounds possible that s/he may just be a cookbook monkey who does things differently from you, but not necessarily any better. Not everyone with more experience than you is going to be better than you, so while it is always wise to critique yourself, don't do so at the cost of your own self confidence.

Get off the energy drinks and get more sleep. Relax. And don't run your sirens any more than absolutely necessary. They don't get you there any faster, and they put everyone's life in jeopardy. I know it takes time to get over the initial excitement, but it is the most important step you could possibly take right now. This job isn't about sirens. It's about people. And if you don't arrive calm and confident enough to care for them properly, then you'd just as well not show up at all.

Good luck, and welcome!

P.S. It says "New Users - READ This First", not POST here first, lol. Chose your post locations carefully.

Not all of the failings within the EMS system and its structure can be attributed to the Fire Service…

That's true. Many can be attributed to volunteers too!

What's so absurd about a 3 mile run, a few pullups, and some crunches?

What is absurd is that you still seem to fail to recognise what this thread is about. It's about STUDENTS voluntarily enrolling into an adult education course in the community. It is NOT about what you personally think your EMPLOYEES should be able to perform. Stay on topic.

I can't speak for Dust but I believe he would answer this question with a resounding yes. At the very least, he has answered the same question previously with a resounding yes.

I agree with him, too. What you're describing in your question is NOT emergency medical services. It's transport medicine. They're not the same.

Agreed. To say that driving a non-emergency ambulance is "EMS" is like saying driving a drinking water delivery truck is being a fireman. Similar tools, but completely different vocations, which should not be confused.

Which takes me, again, back to education. Fix paramedic education and everything else will fall into place. But if you're looking for home health care follow up then I think that would be better handled by nurses.

I agree that this is more of a VNA type function than an EMS function. That said, I can certainly see the value of the programme, in that it mines a wealth of information for system QA and indeed fosters good "customer service" with the community. My two main problems are:

1. The name. It suggests something advanced about the medic's education or scope. It's not advanced. It's just different.

2. The possibility of this programme taking resources from an already over-stretched system.

Well, the only thing military medics (in most cases) come out qualified for is the same thing that any other EMT-B is qualified for, which is very damn little. There is about this much ---><--- difference between a job as an EMT-B and unemployment, so the observation is valid. Unemployment pays better than non-emergency ambulance driving.

Of course, qualifications vary greatly from provider to provider. Not all medics are created equally. There are some with a wallet full of merit badges that don't know shyte, and there are those without all the bling who have acquired a significant education in four to six years of service. Not all military medics are "masters of trauma." In fact, most never even see combat. Some spend an entire career working in a laboratory or running x-rays. Some make great nurses aides, but are experienced in little else. On the other hand, some are overqualified for civilian employment.

But really, the bottom line is that the theory holds true. No matter how good a provider one leaves the military as, s/he is still just an EMT-B in the real world. But most come out of the military with no desire to stay in medicine anyhow, so it's no big deal. They are still more employable than infantrymen, artillerymen, military policemen, tank drivers, and the majority of other veterans, so I don't understand why the concentration on medics.

I do not see any reason to doucument the race in the narrative if you have already indicated it in the data field as race does not change your treatment plan.

Pertinent negatives don't change your treatment plan either, but you must still address them.

If someone is not complaining of any pain, do I not mention anything about that since it doesn't change my treatment plan?

CCFD staffs all their ambulances with Paramedics so I am not sure what you mean by First Responders.

Just like Lone Star said, a first responder is anyone who responds without the ability to transport. And again, transportation is the ONLY modality that EMS offers that is consistently proven to reduce mortality and morbidity. In other words, transportation is the ONLY thing we simply cannot get by without. Even the stupid firemonkeys seem to realise that much, or they wouldn't be whining about the lack of ambulances in the first place, right? Consequently, I just can't understand what it is about this situation that you fail to comprehend.

1. There is X amount of money to spend on EMS.

2. More than half of that money is spent funding non-transporting first responders.

3. There is a serious shortage of transporting EMS units.

4.

Are you smart enough to fill in number 4, or are we wasting our breath on you?

You have to love the propaganda machine that keeps saying that when an ambulance is called, second matter. Really? In what percent of calls does the few minutes difference between when the FD gets there and EMS gets there does it mean anything? I'd say probably less than 1%.

Of course, even if it were 100 percent of the time, then that would only reiterate the need to pay for more ambulances, and not more first responders. Morons.

Care to expand?

If it's not an EMERGENCY, then it is not EMERGENCY MEDICAL SERVICE.

This is almost (but not quite) as bad an idea as sending firemonkey first responders to EMS runs. An unjustifiable deviation from the primary function that creates more problems than it even addresses.

Are there any good agencies outside DC?

All of the good agencies are outside of DC.

I think that if done right this is a good idea.

But, if done right, it wouldn't involve EMS.

We are not talking genocide here...

Perhaps we should be?