Vorenus

We don`t have any real ranking structure, apart from emergency physician/RettAss(Para)/RettSan (EMT). An exception is a MCI, where (only talking about the EMS-side of things) an organisatorial leader EMS (OrgLR) and a leading emergency physician (LNA) is added. Until the OrgLR arrives at the scene, the para of the first ambulance at scene has command.

So, how was your shift with as acting lieutnant, bieber?

My first shift as a newly qualified RA (Para) was with an EMT partner, as were most of the shifts I did in my first months. Takes some nerves to get used to it.

I played PC games some years ago, but not very often. Last september, when I bought my new laptop, I was tempted to get my hands on 2-3 new games with the fancy graphics and all (since I could actually run them then), but found out that I seem to have lost the nerve to play for a longer period. I bought Skyrim back then, which is a great game (and I loved Oblivion some years back) and Assassin`s Creed II (which is also cool, but I just couldn`t get past that one point, so after many fruitless attempts, I gave up).

What I loved years back was Desperados: Wanted Dead or Alive. Awesome game (something like the early Commandos in a Western setting), especially for folks who understand all the funny hints at Western folklore and movies.

All this discussion about aditonal training brings up a concern.

I am considering going for my bacheleors degree in EMS Management through an online university program recognized by NAEMT.

Any thoughts anyone?

What`s your concern?

About your plans: If there is a possible career opportunity to advance to with this, why not? Sounds cool. Make sure it`s a viable and "useful" online university though, I´ve seen some things with these kind of offers that I wasn`t so appealed by.

I´ve recently started distance-learning towards a BA myself, though in a totally EMS-unrelated subject, so far it turns out quite well.

I don`t have anything against tats. For years, I`ve been pondering about getting one myself, but it just never seems the right time (and now the summers coming, it`s out of bounds again, as for the swimming ). Friend of mine is a pretty good tattoo artist and most of my friends are "inked" in some way.

At work, we have a few with visible tattoos, never heard anyone say anything against it. Never saw an EMS tat, though, wouldn`t be too freaked about one getting myself.

OG= Oral Glucose ?

If pat. is fully awake and protective reflexes are intact, then yes.

Only correction to Vorenus' posting: it's not a "must have", european standard EN1789 doesn't require an automatic transport respirator on ambulances (and the old german standard before 1999 didn't as well), but somehow they are available since I could think EMS-wise...

I just had a quick look around the internet, but couldn`t find the whole DIN EN 1789 sheet - but every site I searched mentioned an emergency vent with PEEP on its list for rigs that apply to DIN EN 1789 Typ C (or did you mean it`s not generally necessary, only with Type C rigs?).

EDIT: Btw, it`s not only about getting your hands free (although that is comfortable) - it`s really difficult to keep a steady rate of ventilations when only bagging, especially while moving the pat. around, as well as it`s hard to keep up a continuos pressure level.

It`s really not that big science to operate an emergency respirator. It`s only more accurate than constant bagging, and it`s easier to acchieve the sought oxygen to be transported into the pat. It`s really just like bagging a patient, you also have to be concerned about volume, frequency, pressure - but it`s much harder if done manually with a floppy bag device - so I can`t really see why so many of you seem to be that honour-struck towards a respirator (as I´ve read before).

Now, with one of those fancy, huge ICU vents with the many buttons - that`s obviously a different story.

Around here, anyone has (must have) an emergency respirator on the rig. We`ll get a new Medumat Transport (digital display an all, but weighs like a ton) in a few months.

Hey Lotus, I haven`t been around for a while and am shocked to hear how imminent your situation is.

Thoughts to you and stay strong!

Dude. Im looking at being a paramedic in less than 3 months. And ive taken two drivers ed courses. no tickets no wrecks within the last 3 years neither of which were of my own fault (both when I was 16). Ive been driving since I was fourteen and most of those vehicles were full sized luxury suvs with a similar profile to vanbaulances through multi weather conditions including several trips to the rockies where the sleet and snow came out of no where. And I can tell you I drive those trucks better than a 20 year vet.

You know what my first truck I drove. A 2004 freightliner medium duty. Than my next one which I had a 8 month bond with was a type III 2003 E450 7.3 L powerstroke diesel with a rebuilt motor and transmisission with a MEDTEC box. I ran that truck code three in rural and city streets.

That`s propably just about the arrogance of younger driver`s Gulfmedic was reffering to. Just saying.

You get the rescue randy jitters out of them and run them through scenarios. Assign him to one truck and only one. Have him become "in tune" with his box. Hippyish I know but when I did it it didnt just become an ambulance it became "my truck". It was the cleanest of the entire fleet and I checked fluids on it like clock work before and after shift and rode the mechanics ass religiously when it was about due for something or something was acting up with it. And with that kind of pride you learn to respect your truck and like your limits you learn its. And as far as driving it once all of that is acquired the rest is comes as common sense (low lying poles, trees, electrical wires, diesel truck not meant for hauling ass, potholes are 5 times worse in the back as they are in the front as with the stopping. Its a true bond between man and machine.Thats something a newbie cant learn if hes flipping through a truck a shift. Is when A truck is acting right and when A truck is in need of a mechanics loving hands.

Don`t really care for the hippyish thing either - in the end, you`re not there to care for that "godlike" machine. You`re supposed to drive it. Reality is, you`re often gonna change your wheels - so there`s nothing better than changing wheels during training, so that you can get accustomed to different driving experiences, etc.

Just my cents.

Can`t think of anything at all.

Go figure...

Strikes me as pretty much useless. It only demonstrates what you should notice anyways (decrease of BP, increase of HR) and puts it into a formula.

It may be useful in the classroom to explain the correlation between BP and HR, but I don`t see any use for it in a prehospital enviroment.

Is that the reason why we dont have any

No wonder why I havent seen any french medics.

Might be. Although I`m getting kinda bored by that joke.

Might also be because the french don`t really fancy the English tongue, from what I`ve heard.

Hm... excellent question.

I`d propably evaluate the situation, come to the conclusion that the world is fucked anyways, regardless of what I`d do - lean back, open a beer and light a cigarette and watch the big showdown.

That.......... vvvvvv

10-4 That was understood.

However, one must not be unfriendly. ------> pissing is not my word.....

I don`t think I was unfriendly, but if you think I was - then let me say: it wasn`t intended.

Anyways, I don`t think there´s anything more to say about this.

Jump in and join the forum.

Terrible ..

what do you use for words ?

Honestly, I was just curious. But I did not want a tail comparison or whatever.

I think no matter what we write here, the most important thing is that we do our job well and love what we're doing.

What do you mean?

I was just getting at some points, you know. And I think the tip about looking up the scope of practices of the different levels was pretty valid.

As said, just look at some links about qualification levels. I don`t want that to become a pissing contest about the level of education,

Just have a look at the scope of practice of EMT-Bs, EMT-Is and EMT-Ps and compare them to the scope of a RS.

Thank you for the welcome paramedicmike and Vorenus.

@Vorenus

That's difficult to say. I've learned in the country rescue and was trained according to the old laws. Whether it is good or bad I do not know....

I would be interested in what the different training levels here differs. Then I could better assess where I stand. The people from New York with which I write regularly about medical matters, always said to me that i am something like an EMT- P.

What do you mean with the "old laws"?

Take a quick google search or a look at Wikipedia for a general overview over the qualification levels.

But if you`re a Rettungssanitäter with the normal curriculum, your training level is significantly below an EMT-Paramedic, and better compared to an EMT-Basic.

Purchase German shears. They look like the $5 cheapies but actually cost like $15. They are autoclavable, or downright disposable. Say what you will about us germans, but we know what will cut a pair of jeans.

Lol.

Are you from Germany, mobey? Didn`t know.

There have been alot threads about that already. As I`ve said in the others, I don`t really carry anything that I`ve bought myself. There`s everything in the ambo (as it should be).

Hey Fenta, welcome!

Ít`s getting crowded with all the germans now, isn`t it?

I`m an RA from Thuringia. RS would be more like EMT-B though, I guess.

If I can remember correctly, the reoccuring hypothermia isn`t the biggest problem, but rather the possibility of the occurence of dangerous arrythmias, if the cold blood flows through the heart.

Driving while using your phone is generally forbidden around here (state law).

There`s already a thread about this, check it out:

http://www.emtcity.com/topic/18895-boots/

-Responded to a call for a scratch on the toe due to a cat claw. No blood. Yes, we transported.

-Call to a person who is SOB. FD Medic downgrades and reports PT is a smoker. I ask PT what is going on. PT reports: "I smoke too much." Story comes out that PT has been up for 3 hours, had smoked 3+ packs of cigarettes and held the smoke too long (like with weed) and had smoked weed. Triage's response, "Tell the moron to quit smoking."

3 packs in three hours?!

Is that even possible? I mean time-wise.

LOL it makes me laugh (and kind of cry) that you blokes have a cookie cutter "advanced" class in "life support" for everything under the sun

While I have no specific advice for said class I can offer the following pearls of Kiwisdom (KIwi wisdom) regarding burns

1) Stay at the scene cooling burns unless there are major life threatening problems with the primary survey; running saline in the ambo is nowhere near as good as 20-30 minutes of cool running water at the scene

With less than 10 percent burned body surface, you might use running lukewarm (15-20 Celsius) water for about 10 mins. More than 10 percent burned body surface contraindicate extensive cooling (more than 3 mins), as well as polytrauma, shock, sedation, etc.

Hypothermia is a high potential risk with burns, don`t forget that.

2) If you have it, cover burns with cling film (Glad Wrap or kitchen film) if you don't have it, get it

Any wrapping should be sterile as possible and should at best not touch the burned body surface.

Awesome!

If Braveheart would have had one of those kilts, he might have won against the English...