fakingpatience

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fakingpatience last won the day on May 6 2013

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    Paramedic
  1. I'm moving to California, and trying to puzzle through all the required documents to apply to work at AMR. I received my state california card through reciprocity, but to apply for work I need * CA Drivers’ License * H-6 DMV Print out of Driving Record (Online printout not acceptable) * Ambulance Driver’s License * Medical Examiner’s Card Getting a regular CA driver's license I assume will be a fairly straight forward process, just turning in my other state's license. For the Ambulance driver's license, it says I need to take a test... Does any have information on what is tested? Is there a book available, like there is for regular permit tests to study from? Also, it says a medical examination report is required... Is there only 1 of these, or is there a separate medical examiner's card I need to get also? Thanks in advance for any advice!
  2. Funny EMS Picts

    Not toe pain but transported a patient for gum pain x4 months, already seen a dentist for it, no new changes. Oh and it was 0200 and she was a block from the ER
  3. Israel

    Does anyone on here work EMS in Israel?
  4. Differentiating AVNRT from really regular Af + use of adenosine

    Our protocols specifically said that if you aren't certain if it is SVT or other rapid atrial rhythm to give a trial dose of 6mg adenosine, to slow the rhythm down for diagnostic purposes. Personally the a-fib RVR pt's I've had have been fairly irregular rates, so it wasn't needed, however I did have a pt in a regular a-flutter (1:1 conduction) undecernable to SVT at the rate. Gave 6mg of adenosine, and the rhythm slowed for ~10 seconds, long enough to see the flutter waves and determine a calcium channel blocker was needed (didn't carry cardizem there so opted to not treat and wait till we reached the ER as pt was stable).
  5. New Partners

    Sorry I have been absent from this thread for so long, but glad for the discussion it has generated. Believe me, I am fully aware that the problem is me, not my partner; its not his fault that he is new, he can't change that and he does want to learn, but it is my fault that I am impatient. I have many faults, both as a person and a medic, and before was lucky to have understanding partners who helped me "mask" them at work. Thank you all for the various advice. To answer some questions, I am a new medic (less then a year), and new to the company (just a few months), but was a full time EMT at another agency for 3 years prior, so I'm not brand new to the field. I agree with what some of you said about it being a partnership, not the medic "in charge." I don't like being "the boss" on the truck, am used to working more in partnership with my partners, but up till this point I was spoilt with really good, experienced partners who I could trust (both as an EMT and as a person), and whom I just clicked well with. I didn't need to worry about simple things like even them knowing how to park the ambulance... I've always (including before I got my medic) disliked the saying "An EMT saves the medic," I think that a good partner saves their partner, regardless of the skill level of either. My partner and I had it out after our last call, both spoke our minds and pointed out quite bluntly some of the problems that we were having with one another. Hopefully having it out in the open now will help us both to be more mindful and work together better, I suppose only time will tell. I know for my part I am going to be more conscience of how I speak to my partner on calls, and trying to take time before and after calls to explain things.
  6. Transporting patient possesions

    Perhaps you could tie 8' strap/ backboard straps to the ends of the seatbelt on the bench-seat, to make it longer. Or if that won't work (if the end you need to click it into is flush so you can't tie anything onto it and isn't compatible with the backboard straps) use the backboard straps to tie it to the side of the stretcher, so it can't go anywhere. For better or worse, I think that it is human nature for us to go more out of our way/ try harder to help those who are nice to us and/or acutely ill. Another way to look at it is perhaps not being able to get his wheelchair to the hospital in the ambulance would be a deterrent to him abusing EMS and hospital resources. Does your town have a public bus? If it does then to be ADA compliant they need to have a way to transport wheelchair users also, maybe he'd rather go to a homeless shelter that is on the bus route then part with his wheelchair to go to the hospital just for a bed/ meal. Has your agency looked into contacting any social services resources to work with him?
  7. Transporting patient possesions

    Can the wheelchair fold? What problem did you see when trying to get it to fit into the ambulance?
  8. Transporting patient possesions

    I have typically folded the wheelchairs and placed them by the captains chair or between the bench seat and the stretcher (buckled in). I realize this is probably the "wrong" answer, but in all honestly, in this situation, I simply wouldn't take the wheelchair, and would not go out of my way to arrange transport for the wheelchair after the pt had become physically and verbally abusive towards me. I also know that the director of my company would support me in this decision (especially with the frequent flyer we have that I'm thinking of). We will take him if he wants to go, but if we cannot transport the wheelchair then he will have to go without it, or stay home. Was he acutely ill? Why did he want the wheelchair this time, when the walker has sufficed in the past?
  9. New Partners

    Looking for advice anyone here might have. I'm a new medic, and I just got a brand sparking new EMT partner, just got his EMT-B, has not even worked for a month yet. He's not stupid, and wants to learn, but I guess I'm just trying to find the right balance between showing/ telling him how things need to be done and being too bossy. And as a new medic I still have a million things running through my head, and tend to get frustrated with myself, and then less patient with my partner when I need to walk him through the simple things. Also, he is twice my age, which makes it a little more awkward for me to be the one "in charge"/ mentoring him How do you help your new partners? What were some things you remember your partner doing when you were new that was great or terrible?
  10. Studying in California

    1. What sort of education do you have? I have a bachelors, along with a separate associates for my paramedic certification. 2. What was your career path from college to present? Why did you decide to follow this career path? I started volunteering as an EMT my last year of college, and decided that I liked the field more than what I was getting my degree in, so once I graduated got a full time job as an EMT, then went to paramedic school 3. What are your basic duties performed during a typical day? Week? Month? Do you have a set routine? What are the major job responsibilities? Trying to describe the basic duties isn't easy! Respond to 911 calls and transfers and take care of patients. Also as everyone else mentioned, inspect the truck and other station duties (cleaning up). Don't have much of a routine aside from attempting to check the truck first thing, as you never know when you'll get a call or how long it'll take (we do LDTs also which can take us ~6 hours at a time) 4. How much variety is there on a day-to-day basis? Generally it varies a lot, you never know what you are going to get. 5. How many hours do you work? ~60 6. Does the typical EMT have a set schedule or are the hours flexible? 24 hours on, 48 hours off 7. Which skills do you feel are most important to acquire? Learning how to interact with people. Assessments 8. What types of technology are used and how are they used? How often are changes made when it comes to new technologies? Cardiac monitors, laptops. Frequent changes in terms of new supplies. More then changes for new technologies it is changes in keeping up with current research in best practice. 9. What educational program do you recommend as preparation? What kinds of courses are most valuable in order to gain skills necessary for success in this occupation? College level EMT course (usually 100 level) 10. What degree or certificate do employers look for? What kind of work/internship experience would employers look for in a job applicant? EMT certification. Some places also favor volunteer experience with local ambulance service. 11. How can a person obtain this work experience? Most areas have places that will hire people without experience, to get your first "foot in the door" job. Just remember if they are always hiring and willing to hire brand new people, there is probably a reason for their high turnover. 12. What entry level positions are there? EMT- basic 13. What steps besides meeting educational and experiential requirements are necessary to "break into" this occupation? Make a good impression during school and clinicals 14. What are opportunities for advancement? To what position? Is an advanced degree needed? (If so, in what discipline?) Becoming a paramedic (1-2 years of college), management 15. Is there a typical chain of command in the field? Completely dependent on the agency you work for. At my agencies we have a shift supervisor on duty each shift who is our direct supervisor. Some trucks are run basic/ paramedic, and at some agencies the paramedic is considered in charge of the ambulance. 16. What are the different salary ranges? Depends where you live. For emt-b I have seen hourly rates range from $7.25 to $13 17. What other kinds of workers frequently interact with this position? PD, fire, nurses, doctors, aides 18. What are the main or most important personal characteristics for success in the field? Willingness to learn. Able to take a joke (you will be teased by your coworkers, but not usually in a malicious manner). Comfortable with people. 19. What are the satisfying aspects of your work? I love my job, getting to help people in their times of need, even if the help just consists of comforting them. 20. What are the dissatisfying aspects of the work? Is this typical of the field? Low pay, long hours can take a toll on you. Lack of respect from other agencis 21. How would you describe the atmosphere/culture of the work place? Friendly, however there is frequently a lot of gossip 22. Is there evidence of differential treatment between men and women EMTs with respect to job duties, pay, and opportunities for advancement? Depends where you work. For the most part I have not experienced any differential treatment, but there will always be 1 or 2 assholes out there. 23. What do you feel are the toughest types of problems and decisions that you must make? Ethical dilemmas when it comes to patient care. Not second guessing yourself 24. What are the demands and frustrations that typically accompany this type of work? What are the greatest pressures, strains or anxieties in the work? As said above, long hours, low pay, lack of respect from other agencies (police, fire, drs, and nurses) 25. What do you know now which would have been helpful to know when you were a student? Realize that what you will learn in school is important, but the real learning (especially for EMTs) begins in the streets. 26. Any other important questions that I have not asked that would be helpful in learning about the job or occupation? Thank you for your time.
  11. ED Wait Times

    Once we are on hospital property, the patient is technically the hospital's patient. We are waiting inside a hallway of the ER for a room, the only equipment we have with us is the cardiac monitor (which some supervisors encouraged us to turn off once we had been triaged and were just waiting for a room, to "show" the hospital the patient was their responsibility... I refused to do that). We were not allowed to further treat the patient, as they were no longer "our" patient, and as the patient was not in an ER room and being seen by a dr, the hospital would not treat them either. On 1 call I was able to give my waiting pt additional pain medication that I had left over in the vial (was going to waste) with permission from the attending Dr, but this was an exception, not at all the norm. If we had fluids or anything running we would continue that while waiting, but not start anything new. Now typically we were not kept waiting with "critical" patients, however on occasion we have been (such as the a-fib w/ RVR patient, another patient on CPAP... both of these were at the same hospital) Believe me, I know how bad for patient care this sounds, thats why I got out of that system as soon as possible (started my new job this month!)
  12. ED Wait Times

    My longest wait time was 6 hours. Average was an hour or two. I saw 2 major problems with the hospital systems (not counting the fact they were taking an ambulance off the street), 1, they wouldn't let us put BS patients in the waiting room (I got told "I already have to many patients out there, that won't help me any" when asking the charge nurse if we could put our patient there). And 2, occasionally we were waiting the extended times with actually sick patients, who are then not getting any further treatment, as we are on hospital grounds and can no longer treat them; a few weeks ago I waited an hour with a patient in a-fib w/ RVR rate ~170, after telling the staff numerous times my concern for her. The hospitals would have us stay with patients even if they had open beds, if they didn't have enough staff to "open" those rooms. I considered this using us as extra staff, why pay to have appropriate staffing when you can just keep EMS crews there to watch the patients for you? Officially we weren't supposed to be kept waiting longer than 30 mins, but no company in the area would let the crews put the patient in an open bed and leave, as this would anger the hospitals, and their main concern was keeping them happy to keep to contracts.
  13. Food poisoning and antiemetics

    I tried to find some research on this but didn't see anything, so I'm hoping someone here may have some insight! If you have a patient you believe has food poisoning, and is nauseous/ vomiting, should you still give an antiemetic? Or is it better for the body to allow them to vomit to get rid of the "poison".
  14. NIBP

    Going off of this, which cuff does everyone find to be more accurate on our "large" patients? I alternate between using the maroon large adult cuff on the upper arm, or the regular blue one on the lower arm, but don't seem to get reliable results with either one. My problem with the larger cuff is I thought the blood pressure cuff is only supposed to take up a max of 2/3 of the length of the upper arm (don't quote me on the number, but I think it somewhere around there), but the larger cuff is not only longer, it is wider, so it ends up covering almost all of the upper arm. What these patients need is a cuff that is longer, not wider.