Capman

NREMT' This needs to be considered as well. In my area, a lot of the outline towns that do not have an ambulance base are volunteer services. Volunteer first responders show up prior to the ambulance to offer care. Most of these first responders are the EMT's and Paramedics who work full time, but are responding on their day off. Does the term volunteer some how degrade patient care, or the fact that they are responding in blue jeans and boots? Of course when I say first responders, I don't mean the license level.

"By saying you work with your hands AND your brain, you werent being bold, you were being insulting. Theres a difference." Duly noted! But... It was already pointed out and hindsight makes me wish I hadn't worded it like that, as going back and reading it I accepted that as an arrogant statement and apologized. So let's not beat a dead horse and harp on a poor post. It does not contribute to this topic. Thanks

Keep in mind cat' that not everyone does this fresh out of high school. Also keep in mind that many who do this still have occupations such as mechanics, farmers (in my area), truck drivers, etc. It is a field that does not segregate those who may not have the most spectacular resume. My best advice to you is to take the basic, attend all the trainings that you can, and enroll in the paramedic program, and you should be well on your way to landing yourself a job in EMS. You sound like you have a positive attitude and I encourage and welcome that in the new men and women coming into the field. I wish you the best of luck. Keep us posted and feel free to ask questions.

Wow! Sounds pretty deep 4cmk6. Sorry to hear that.

Are the absence of neuro deficits grounds alone for a spinal rule out? Think about it, has every spinal injury that you have been on presented with neuro deficits? There have been some I have been to that have not. That is what causes me to worry. If the mechanism of injury is there, and there is a distracting injury/pain, the potential C-spine injury will always be sitting in the back of my head haunting me if I do a rule out based on the absence of neuro deficits. What are the additional rule outs in your C-spine protocol? I'm curious to see if all of locations vary on this. Do not refer to PHTLS to answer this, because we know it is the same for all of us. Thanks

Why? Gotta' share some reasons.

"Well if you guys would just buy 'em dinner first the death rate may be lower!" NICE!!! :laughing3:

LOL! Actually, in Maine; these cause more deaths than spiders or any other animal.....

Hey brent'... That is a great link. Hope it works for the OP. If not, I can use that. Thanks

Those are all valid points mateo', but the problem I see, is that remote possibility where a penetrating injury may have compromised the spinal cord. With penetrating injuries, there is that distracting injury (the entry wound). In this case, a patient can not indicate pain in the back/spine due to the distraction of excruciating pain at the entry wound. I don't know... I think this one will divide the forum. The question is... When can we expect to see it back in PHTLS??? Or will it stay out of the books for good???

Ditto! What's more frustrating is when you have one of those shifts where you sit around all day, then midnight hits and its when it all starts. You can almost predict when this is going to happen as you sit around too.

I just gave a lecture on Toxicology last week. The Brady books put snake bites, Black Widow bites, Scorpion stings, and things in this chapter. It was a very interesting class. We do not get any of those calls around here. Of course the potential is there, especially at the Maine Military Authority. Those Hummers come in with a lot of Black Widows and other pests in them.

Well, it's like this ruff' and connie'. You know this place as well as I do. I've been charred for stating I have a tatoo. I've seen others verbally assaulted for simply asking a question. Is it right? Nah, probably not. But, right or wrong, this is a forum where we discuss patient care. I believe the intent here gathering information to improve in all areas including patient patient care. So statements such as... "Personally, I like being able to help someone with a physical injury or illness that I can put my hands on and treat. Can't do that with psych patients." Kind of bothered me a little bit. Why? Because I get the feeling that if others who wander through this forum to see what we and this profession are all about, it will somewhat sell us short of who we are and what we do. But, for fear of being thought of as a jerk, and maybe it was a bit arrogant.... Please accept my apologies. Sometimes these old fingers of mine get away from me and I don't want to leave here thinking anyone hates me. Carry on.

It is the same at our hospital based service as well strip'. We get the Avatar Score Survey lecture every three months. "Avatar Scores are down, we need to improve customer service" Direct quote. Those who wish to knock it and beat it down.... Go right ahead, but that is how it is!

Great topic UMSTUDENT, I have to do some homework on this one though. Will get back to this one as soon as I do.

Well Connie'.... A true psych' patient is just as much a patient as any other patient. While we are not psychiatrists, myself and my EMS students receive an adequate amount of class room content and clinical time with psychiatric emergencies. This prepares them for what they will encounter in the EMS field. If you can not handle a psych' patient for the short period of time associated with an ambulance call, then perhaps you should take some CEU's or an extra class pertaining to psych' patients. "We might get a call for someone who's depressed, show up on-scene, and they're aiming a shotgun at us" Ah! Yes, the common EMT gripe about how "Dangerous" our job is. This must come from all those incidents where EMS personnel have had shot guns pointed at our face. Sure it could happen, but this comment is way over used by some EMTs. You are probably not going to get any empathy out of any of the seasoned EMT/Paramedic's in here with that comment. "Personally, I like being able to help someone with a physical injury or illness that I can put my hands on and treat. Can't do that with psych patients." Whoa! Careful there my friend. Statements like that somewhat sell our profession short of its capabilities. I have helped many psych' patients, so have my co-workers, and so have the thousands of visitors here at the city. Maybe it didn't require me "putting my hands on them". But then again, that may be the difference between you and I. You like to work with your hands, and as for myself... I like to work with my hands and my brain! Sorry for being bold, but I'm not about to let you sell this profession short! [-X

Hey, I'm not going to sit here and defend my service when deep down I know that you are right on target with what you are saying. But keep in mind that it is not my job to sit here and bash my service either. It is far from perfect, and money is one of the large problems that we face here. The fact of the matter is that we are hospital owned and getting them to spend some cash to make right is easier said than done. They purchased multiple Tough Books for the purpose of doing this, but now do not want to shell out the "claimed" $1000 per license per computer to put the Service Bridge software on these Tough Books so we can do run reports off line. So, we can only use the on line version through Maine EMS, which as you can tell in our situation; poses a problem. This very topic has plagued our service since going electronic last January. You can show me all the fancy portable printers and other ways to get the hospital their run form in the fashion you say, but all it's going to do is make me jealous because our service will probably never get it. So, I hear what you are saying and I agree whole heartedly, but I don't make the rules, I just follow them. Maybe if they get their a$$ in a sling about this, they may consider improving in areas such as this. Thanks for the info'

That makes sense to some extent but... Completing a run report at the hospital is one thing if you are a service that still uses that stuff they used to call paper. Maine EMS is all electronic. It is new and has many issues yet to be resolved. http://www.memsrr.org/ So.... If the hospital is cranky because they don't have a copy of our run forms, then they had better put computers on line for the paramedics to use to enter run forms prior to leaving the hospital. Which; by the way, is something that they have not done. So, be careful about slamming services about practices that may not necessarily be within their control. Also, remember this is Maine. You could at least give us an "atta' boy" for having cable to watch "Turd Watch". :)/

Rough on a belt??? How are you rough on a belt? C'mon, you can level with us.... Duty belts look COOL!

Classic! :laughing3: "save life and limb at any cost" Not to beat a dead horse or anything, but.... .... may it be your cost! Stick around for a little bit, you'll learn how it works.

You have to do your run reports right there? We can do our run reports back at the base.

Yeah, I guess that I can't use the word "always" dust'. PHTLS only dates back 8 years for myself. I'm not really sure what the standards were prior to that.

That is how it is here. Why would you have to wait in the ER? No rooms? Put them on a cot in the hallway of the ER. I couldn't imagine waiting around with patients at the hospital. "Dump and Pump" Great way of putting it Spen'. Never heard that one around these parts. Now I get to introduce it. LOL

Well, welcome to EMS! Every service has the regulars. Those who call several times a week and swear they are dying. Those who call for runny noses. Those who call because they can not sleep at 0300 in the morning. Those who want an ambulance because they are not eating well, or are feeling week, depressed, can't move their bowels................ You get the point. The short of it is, it will never change. In fact it is getting worse. However, keep in mind that these people keep you employed. You either deal with it or move on. As for the all the information you learn in school that you feel has no use for you in the EMS scene outside of school.... It is what separates us from trained monkeys. When you get called to a patient who is suffering from a hypoglycemic episode, do you know why you push D50 or do you just know that you are supposed to push D50. If your answer is that you just know that your supposed to push D50 or any other procedure or med administration, then you may want to choose another profession. I teach Medical Emergencies which is a paramedic level class for the EMS degree in Northern Maine. I can tell you, that the eyes roll as I lecture on the immunology, acid base balance, the nervous system, nephrology, Etc. The reason eyes roll from students, because they too feel that it is unimportant. By the time my semester ends, the students understand why this material is important, and they also understand why they do something not just that they are supposed to do something. So, I will tell you that you will not get many people on your side when it comes to bashing knowledge base material. I am sorry if I sound like I'm lecturing you, but I feel that you have got a bit to learn about EMS if you plan on advancing.