P_Instructor

Nature, try this link: https://www.nremt.org/nremt/EMTServices/verify_cand_status.asp?link=2 I use this all the time and works great. It give status if registered on NREMT site, if authorized to test, and pass/fail result of exam.

Each textbook is unique in it's own way. You must remember that there are differences in opinions based upon which author(s) feel is the best way to present information. Honestly, if you are to instruct classes for the Paramedic, always remember that the finished product must be able to understand and apply all aspect of cognitive, affective, and psychomotor objectives according to the latest national standards. It would be up to you to research each text and decide which you would feel best serves this purpose. Content must be able to be understandable, and many authors go way above the student's intellect. This is where you must, as an instructor, be able to explain to the student what the author is truely stating, even though it may be their own opinion. You will probably have many differences of opinion on which is the best text. Good luck.

Sounds like the custodian for the restrooms at the international airport......you know, like us......putting up with the shit.

Yup......I'm just glad that I retired before this happened. I can watch it all on CNN, Fox, etc., while in my recliner........ at the lake cabin.......on a beautiful summer day........drinking a brewski...........wife rubbing my feet...........

Thanks, have done all the above, scenario and in real life (United Flt 232). Have done the ambulance scenario also as local service had deadly incident. Keep sending ideas though, I really appreciate it. I was kinda thinking on the lines of possible 5-6 pediatrics that are sick in school, and to make it even more difficult (but will really test the assessment skill) make it a school for the deaf. Again thanks and keep sending them.

You are correct with your thinking, but to really make sure everything is documented, don't just use the 'is this a patient' idea. Document any contact whether patient or not, complaint of not, arrived scene or not. With this understanding, the paperwork stinks, but better than your butt. Get a policy Get a new QA/QI person Sounds like you need both.

What???????????? You're kidding, aren't ya.........

It sucks, but you need to document each and every call regardless of patient contact or not. Even the documentation may not keep you out of trouble in some instances. Example: I was dispatched to a residence for male with chest pains. While responding, our Comm Center advised that patient called 911 now and refuses any help, does not want EMS, fire, or PD. I even documented this 'cancelled call' with all particulars of address, information obtained over the radio, times and location we were at. Approximately 25 minutes later, another crew dispatched to same location for 'unconscious party.' Fire arrived scene a few minutes prior to EMS and radioed that patient 'Code Blue, CPR in progress." Moral - the wife of the patient initially called 911 because patient was complaining of severe chest pains. Patient then himself called 911 to cancel without the wife knowing. Wife was apparently hysterical because it took EMS 30 minutes to respond to her request. Was going to court until my documentation of 'cancelled call' came to light. You never know when something can or may happen, so even the most mundane call should be documented in some fashion whether you like it or not. Secondly, it is also your responsibility even though you are the basic compared to the medic. You both make up the crew that responded to the patient's requests, and are both equally responsible. I know there will be others responses to this thread, pro and con. Do what you need to do, even with the aspect it still may go to court.

Quit beating yourself up. These things can always happen even with patients that have no prior histories. He sounds like the perverbial train wreck that finally de-railed. About the only thing(s) you could have obtained was a more complete history of how the patient has been during his initial hospitalization and if there were any complications that could be expected........but that report could have taken hours and you usually never can get that from the floor nurse. Bad way to think of this, but he was maintaining in your presence.......he only changed after someone else took over and want to pass the blame. You can only do what you can do.

Ahhh.....are you the true descripton of 'klutz'??????

Just be happy you have all three options available. Use what is best for the patient and especially your own well being. Make sure you have (or obtain one) an agreement with other public service agencies for lifting assistance. It is common in my area to use the FD for lifting assistance, especially the bariatric patients. It has come to the point that the FD responds to places for 'lift assist' requests only, and if they have more than they bargained for, call us for assistance if we're available. Heck, most of the time they're just sitting around anyhow. Keep yourself in shape and routinely practice with the cot, stairchair, a wheelchair, or whatever other device you have to become more aware of how to handle the 'strenuous' situations.

Once you train and use the King, you will find it even easier than the Combitube. As a secondary device for the paramedic, it's great. Our state has even adopted the King as the replacement for the Combitube even at the First Responder level.

Proud to fail student?????????? You have got to ge kidding??????????? In regards to the restructuring which majority of people disagree..........take a hint!!!! The instructors position is not to try to fail students, but to prepare them for the Paramedic testing and hopefully subsequent employment. You should be trying to help the student as much as you can, and direct them to be successful. Granted, if the student is not capable to meet the standards of what is taught, then dismiss them with grace and encourage them to try again after a period of reflection or EMT experience. Being 'proud' of failing someone is not what a good instructor does.

Again, not knowing how the situation is in the NE.... Many employers today seem to look for the recent graduate to be a perspective employee. This tends to make their company look better. I am not going to get into the debate of degree versus non-degree programs as this is bashed all over this site. I prefer the degree program (as I teach one), and have seen many of my graduates gain employment over students from programs that did not offer the degree. With degree programs, there seems to be more emphasis on the anatomy and physiology, base mathematical equation, and other scientific education....all which IMO tends to round out the aspect of pre-hospital care that Paramedics provide. I am very sure that others medics that frequent this site will offer there own opinions, both for and against the degree programs. Go with what fits you best.

Every state and every program are different in what they provide as well is what is needed in the job sector. I am not familiar with what the NE does, but it sounds like there are different pathways you can venture, and is seems you are looking into this. Research farther into what your future employers are wanting and then drive that path. Be aware of many forks in the road as whichever program or level you go through requires extensive/intensive book work and skill preparation. If you are having difficulty in book work, the path you may want to travel is the EMT-I, then possibly the Paramedic. Only you know what you can do yourself if the dedication is there. Do ever forget the light at the end of the tunnel. If you decide the Paramedic route, you will have to be dedicated to the class 110 percent. I would also advise you to go through a degree program as this will may you more marketable.

One must understand the basic aspect of what Atropine is....a parasypathetic blocker. It's properties do not actually speed up the heart rate, but blocks a parasympathetic response which create the myocardium to revert back to it's intrinsic rate values (approx. 60 sinus/atrial and approx. 40 ventricular) in cases of bradycardia due to a parasympathetic response. Atropine used in bradycardic PEA is only an attempt to block the receptors that relay a parasympathetic response if it is there. Usually this is very rare...if at all. It is also why atropine is not routinely used in a slow rate high degree AV Block as this is not what the problem is. Atropine was a staple years ago in cardiac arrest after Epinephrine, however it's effacy did not warrent further use, and now it seems the same for bradycardic PEA.

Valium, Versed, Vitamin H (Haldol), Sledge Hammer.....whatever works with your safety in mind, do what you have to do. If you get the PD involved, you will probably will have to deal with the tasered patient, etc. You might want your Med Dir. to revamp the sedation/restraint protocol to meet your needs if you deal with a number of 'this' type of patient........

Question....is the intermediate that is being taught to you in lines of the old curriculum, or is it based to the new AEMT standard?

Interesting.....Was the compound fx angulated? Were the bone ends exposed? Usually (insert your opinion of this), traction/sager splints are utilized for non-severe angulated mid-shaft femur fractures only. If the bone ends have already been reduced, how are you to know. Your primary objective for these devices are elongating the fracture site as not to create more damage with the sharp bone ends. Also, they (supposedly) reduce pain from nerve ending irritation. Ha. Many can do this with proper splinting with other devices, and pain medication (if authorized). I can think of only one time that I had an isolated mid-shaft closed femur fracture where we used the traction splint. The majority of my cases were splint in place, and not compromise the distal circulation. If the bone ends are exposed, by reducing the fracture in line, you will also cause more tissue and possible nerve/vascular damage as the bone ends align. Open/exposed, probably not by me, open/non-exposed, depends on many other factors found with assessment.

Does anyone have insite to what this really means to the EMS provider? EMS Approved as an Emergency Medicine Subspecialty East Lansing, MI – September 28, 2010 -- The American Board of Emergency Medicine (ABEM) announces that the subspecialty of Emergency Medical Services (EMS) was approved by the American Board of Medical Specialties (ABMS) at the General Assembly of its members on September 23, 2010. EMS is a medical subspecialty that involves prehospital emergency patient care, including initial patient stabilization, treatment, and transport in specially equipped ambulances or helicopters to hospitals. “The purpose of subspecialty certification in EMS is to standardize physician training and qualifications for EMS practice, to improve patient safety and enhance the quality of emergency medical care provided to patients in the prehospital environment, and to facilitate further integration of prehospital patient treatment into the continuum of patient care. We are pleased that EMS has been recognized by ABMS as a clinical discipline that extends emergency care to the acutely ill and injured patient in the prehospital venue.” stated Mark T. Steele, M.D., ABEM President. EMS becomes the sixth subspecialty available to ABEM diplomates along with Medical Toxicology, Pediatric Emergency Medicine, Sports Medicine, Undersea and Hyperbaric Medicine, and Hospice and Palliative Medicine. The development of EMS as a subspecialty has been discussed for many years but it was through the concerted efforts of the National Association of EMS Physicians, the American College of Emergency Physicians, the Society for Academic Emergency Medicine, and ABEM that certification in the subspecialty was approved. ABEM has assembled an EMS Examination Task Force composed of 12 EMS physicians that is working on the development of the EMS subspecialty examination and maintenance of certification program. It is anticipated that the first examination will be given in the fall of 2013.

Used the ammonia in the past, have done the hand drop, etc..... experience and exposure to the 'fakers' only makes you more aware in certain instances. Why do more harm. Look at the patient. Corneal pain, why. Just simply check without them noticing (of course their eyes are closed), lightly touch the eyelash. 99.99999% of your 'fakers' will have a eyelid flinch. Usually (percentage data unknown), the fakers will have a positive reflex, where the real patients will not. Just a tidbit. Does no harm also.

Dwayne......don't feel alone buddy......you would have many (including myself) accomplices with you in court!