fakingpatience

I don't know about Alberta EMT, but I am a basic working on an ALS ambulance. I get ALS experience watching my medic partner on ALS calls, and assisting them with ALS skills (putting the pt on the monitor, setting up the line...). I have worked as a basic on an EMT/ medic ambulance, and also as a third rider on dual medic or medic/ EMT ambulances (company used both, depending on staffing). In my experience (and this is from the outside looking in, as I am not the medic), the true difference is how well the partners work together, regardless of their levels. BLS saves ALS is bull, IMO, a good partner saves their partner. I noticed my partner putting limb leads on the pt's fake legs and pointed it out to him that this was why the monitor wasn't getting a good reading. This had nothing to do with my being a basic, but being comfortable enough w/ my partner and our routine to tell him. Personally, I think that when I become a medic, I would like to have a medic partner, just to make sure I don't make any stupid mistakes. However, I have coworkers who think that a new medic needs to be "thrown into the fire" and having a dual medic truck will only hinder them. In the long run though, I would rather work with a partner I trust, regardless of their skill level.

I think that there are two separate issues being looked at here. We have the title issue, of paramedics teaching EMT classes. Then, as someone mentioned, the idea of paramedics being instructors to patients. A competent paramedic should be able to educate the public on certain issues pertaining to their health, and perhaps there should be a section of paramedic education focused on this, as they have for RNs. However, I don't think that paramedic students should be forced to teach BLS. As others have mentioned, it takes a lot more then knowledge of the information to be a good teacher. In some aspects, teaching is one of those things where you either have it or you don't. You need to be enthusiastic, and invested in teaching, and the enthusiasm will rub off on your students. Some people just aren't that good at making speeches in front of large groups (think a class of 25+), and as a paramedic, that isn't necessarily a skill that you need to possess. Likewise, the ability to reframe a concept, and explain it in a few different ways so more people will understand is also necessary for an effective teacher. There should be a certification/ degree separate from the initial paramedic cert/ degree necessary to teach any BLS or ALS class.

Good coworkers make all the difference! Most of the trucks I am on are called "peak cars", and they go out of service at night, so no one to relieve us. I heard of people's relief going to the hospital if they are stuck there waiting for a bed for a pt, and trading there, and that sounds pretty ideal, if you can't clear the hospital. Why can't you wash the trucks if the weather is bad? Do you do it outside?

Our rigs are supposed to get washed before end of shift every night/ morning. Our supervisors even expect us to stay late if we had a late call to wash the truck... There is no rule how often the inside gets cleaned. I have never seen anyone at my new company mop down the floor inside, but we do get a towel and wipe the floor down (it is really snowy/ slushy outside, so the floors get really wet and dirty). Equipment gets cleaned when ever the crew feels like it. Usually when I am starting my shift, I wipe down the grab bar at the ceiling, the door handles, the bench seat, monitor, the steering wheel, and the siren controls, and anything else that looks dirty. I agree that the trucks should be cleaned, but I get annoyed that we are expected to stay late to wash them.

I understand what you are getting at here, but wanted to point out a couple things. First and foremost, gender identity has nothing to do w/ sexuality! A person who is born biologically male can feel as though he is meant to be female regardless of his sexual orientation. Regardless, I doubt the military would cover such a surgery, as it is not deemed "medically necessary." As an aside, sorry I have been so absent from the other discussions I have been involved in, I have been really caught up w/ work lately.

In my system, we transport pretty much all psychiatric, and a good number of drunk patients to the ER, and PD follows behind in their car, if at all. We are not allowed to out and out refuse a request from PD to transport the pt, even if we feel the pt is very violent. We can request that they ride along, but we cannot refuse. Oh, and all we have are soft restraints, no hard restraints or chemical restraints . Also, PD can cuff a patient, and then only follow in their car behind the ambulance, not ride along. To me, if the patient is handcuffed, I would want a police officer in the ambulance with me incase the patient a. uses their handcuffs as a weapon, or b. deteriorates, and I need better access then what I can get with the handcuffs on. Unfortunately, my company will not support us if we say we don't feel safe with the patient...

Not trying to detract from the topic , but from reading the article, it seems the EMT was driving the ambulance with no one in it, after she had already dropped off her partner. Why would someone be in the ambulance w/ out their partner? Sorry if this is off topic, that part just confused me, and I was hoping someone can help explain it. My thoughts are going out to everyone involved in the accident... hopefully they have as good an outcome as possible.

Good to think about the traction splint, since it is one we use so rarely (I have never used it) It is aways good to mental go over it again. On the same note, would to try and realign any other fx? I was taught yes, 1 try, unless you feel resistance, but some people here say no, never try.

I ended up getting a pair of women's Magnum stealth force water proof with the side zipper. They are much more comfortable for me then the other brands I tried, good from the first day of wearing They don't zip on and off as easily as my older version of the magnums, they changed the zipper, but my zipper broke on my old boots, and I think this design is stronger

Sometimes the surgery, though risky, will actually greatly increase the pt's quality of life. Take for example the elderly person who breaks their hip who has a cardiac hx. The surgery would be risky, and chances for survival are slim, but their options are living the rest of their life in a bed in a nursing home, unable to move, or attempting the surgery, and have a much better quality of life if the surgery is successful. I don' t think there is a blanket answer to the question of care for the elderly, it is entirely case by case.

Loved this video... got an extra laugh out of it because our local fire departments have been known to do some of the stuff fire did in this video

I'll take a stab at it... My answers are in red Wow, no wonder I always get teased for being so clueless about popculture!

Yeah, I usually ask partners how they like to run a call when we start a shift, but the answer I get usually is "it depends" and they don't elaborate. I work with partner of the week (aka someone different) a lot, and it is frustrating not to have the jive, and know how to work together well.

I have a question for y'all about giving albuterol to a patient. I know that the indication for albuterol is wheezes. I also heard that CHF is a contraindication for albuterol because the broncodialators in the med will allow more fluids into the lungs, increasing the difficulty breathing (Someone correct me if this explication is wrong). So what do you do for the patient who has a hx of both asthma/ COPD and CHF and has diminished lung sounds? Would you give the albuterol/ duoneb until you can hear better lung sounds, and base your further treatment off of that? What if the cause of the SOB is CHF and you have now made it worse? CPAP? Sorry if the question above is convoluted, I was wondering because I had a pt recently who had hx of CHF, but no other lung hx, and was diminished on the L side, and my partner gave her a duo neb treatment, even though she was stating at 98% RA, because her RR was about 30 (no other signs of SOB) When I was initially certified to give neb albuterol, I never learned that CHF was a contraindication for it, and it scares me that I didn't learn all the information about a drug I was certified to give. If y'all have any good resources for this info, that would be great, but I would also like to discuss it here, I always learned best from class discussions

I have had the opportunity to work with many different partners in EMS, and I was thinking what traits/ things a partner did that I liked, here are some of them: Offer to drive if I have been driving all day and we are ping ponging posts, or if I just got food Let me tech the BLS calls... I didn't get in this to be just a chauffeur! Will interact with me, at least some of the shift, not just sit there texting/ playing games on their phones Lets me ask questions about what they are doing with an ALS patient w/ out getting defensive, and can explain things well Is willing to teach Is willing to learn/ admit they are wrong Going along with the above, lets me point out a mistake they may have made (like putting limb leads on fake legs!) w/out getting insulted Will point out my mistakes in a kind way Likes being a paramedic/ EMT What are some qualities you like in your partner/ things they do that make you enjoy the shift more?

I used this book to study http://www.amazon.com/EMT-Basic-Interactive-Flashcards-Preps-Premium/dp/0738601233 I love flash cards, and that is what helped me. Actually, for me, I don't think the studying was as much about learning the information, because you should know it by the end of class, but assuring myself that I knew the info, to be more confident for the test. That said, I was still a nervous reck after my NREMT test, sure I failed... i didn't

Really? Everywhere I applied looked at my driving record, and wouldn't hire a basic w/ out a clean record for a number of years. I also just had a coworker who was essentially fired for getting a DUI. I agree with what was said above, your chances are much better getting hired somewhere as a non driving medic then a non driving basic.

For class, I just bought the cheap stuff. A pair of dickies, a plain white button down shirt, and a $20 pair of black boots from walmart. Even if you plan on getting into EMS, you don't know what their uniform will be exactly. IMO, just don't wear something with frills/ extra strings for decoration that could get caught on something or pulled if you get a violent patient.

Suicides and suicide attempts always increase by the holidays. It is a stressful time for many people, with all the family expectations and let downs. Large family gatherings are stressful for a multitude of reasons, and if you don't have a family to gather with, it can be depressing. Society and the multimedia perpetuate the idea that everyone needs to have the 'perfect holiday.' Tie that in with the fact that many more people are now financially unable to provide a 'perfect' holiday for their families this year, and they feel like a failure. That said, I HATE dealing with family on scene at crap calls. I can work a code, or see a DOA no problem, but hearing the family grieve afterwards gets to me. I think part of that is because there is nothing we can do for them. I worked a code on a youngish guy, and I don't remember anything about the code, but I remember the toddlers wide eyes, watching us try and save his daddy....

I hate it when pt's family try and follow the ambulance, even when we are driving cold. if I go through a yellow light, to avoid a hard stop for my partner in the back, sometimes the family will drive right through the red light. One trick that one of my partners here uses is getting the family to leave first to go to the hospital, while we are getting everything set up in the back, so they have no opportunity to follow us

My brain is weird, I tell that to anyone who knows me. I have never been in an ambulance accident (knock on wood!), but anytime anything stressful is going on, I tend to notice weird details. I am trying to think of an example of this, but drawing a blank, but just wanted to let you know you are not weird for thinking random things at stressful times. Or maybe you are weird, but then I am too

Thank you Herbie, you are absolutely correct; I was not questioning the doctors call, I am merely asking questions about it, to help me learn. I don't think anyone would go against what a doctor says to do unless you have an absolute argument why it would be detrimental to your patient. Here is my thoughts on boarding a patient who has already been up and moving around for a significant amount of time (not relating to the example from the original call). How would sitting still on a cot in the ambulance cause the patient to move in any direction they had not already? Instead the backboard is going to cause increased pain, and if you don't pad properly (and I don't know many people who do) could cause more movement of the back when you bump up and down. I am lucky with my company now, where we have liberal back boarding protocols. We don't need to board every fall (from standing) w/ possible head injury/ ETOH/ drugs on board, only if they have a specific complaint of neck/ back pain. Dwayne, I have seen you mention putting a folded blanket on the backboard before boarding your patient before. I was going to try this on my call, but my partner disagreed, saying that the blanket would cause the patient to slide around to much on the backboard. What has been your experience with this? 4c6: I used to have vacuum splint at my old agency, and I loved them for splinting extremities. I have never seen a full body vacuum splint though! It makes since that it would work better (it does the padding for you), and I would assume it would be more comfortable for the patient... through it doesn't take much to be more comfortable then a LBB

This was not my call, but I was in the ER, and helped the crew who took it, so I don't know all the details. The crew was called to our local hospital to take a patient to the large trauma center in the city. Pt had fallen from a tree yesterday, but decided not to get seen at the ER, as she had cut up her face pretty badly, and was unable to see well enough to drive herself. Came in today w/ complaints of facial trauma (had one lac on forehead down to bone, and other swelling), and back pain. Our local hospital doesn't have CT or MRI, but they did an x-ray of pt's spine, and found a couple fractured vertebrae (I don't remember which, sorry!) Pt was sitting up in hospital bed with a C-Collar on. The hospital stated that the patient had to be put onto a backboard prior to transport to the trauma center. Here is where I am confused. If the pt injured herself yesterday, and was already up and walking around, even though we now know she does have fractured vertebrae, can't we assume at this point that the fractures are stable? I was under the impression that if a patient was walking around for that amount of time, they had essentially 'cleared' their own c-spine of an unstable fracture, and therefore, even if they had a fracture, it would make no difference being back boarded or not, but the back board would cause additional pain. The crew who took this call didn't question why she needed to be boarded, so I couldn't find out the official answer. I asked them if, they had received this call today to the patients house, of a patient who fell yesterday, and was complaining of back pain, would they back board, and they all agreed no. What is the benefit of back boarding this patient solely for transport?