thbarnes

UPDATE: I relayed my frustrations with the OR to my clinical coordinator. She sympathized, but I still need a minimum of 12 hours in the OR and 5 successful intubations (ET or LMA) prior to graduation. I contacted a family friend who is a CRNA and I will be working with her next time I go in, she's great and promised me some hands-on time, that way I can get those intubations I need. I feel like I should point that while our OR clinical is only 12 (not 8 ) hours long, the required number of clinical hours for Paramedic candidates in my state/in our program has increased almost every year for the past several years. The areas we orient in have expanded from the ambulance and ER to the Trauma ICU, Neonatal ICU, Labor and Delivery, Medical Psychiatry, Behavioral Psychiatry, Dialysis Clinic, Cardiac Cath Lab, and of course OR. I should also point out I am in a 'bridge' program of sorts, an Accelerated Paramedic program for medical personnel with documented medical training and patient contact, incl. Army medics, Naval corpsman, experienced EMTs, and LPNs. Many of us not only have airway experience, but have intubation experience.

Ug! I was supposed to practice intubation in the OR this morning, but was brushed aside by med, anesthesiologist assistant, and certified nurse students. They made it clear I wasn't going to get an ET tube in edge-wise! What angers me is that it's going to be those same med students who are going to bitch me out on their ER residency when my patient in arrest isn't intubated. And when the anesthesiologist looks at me and says "Well, they need to learn" I want to ask him why he thinks I don't need to learn on my one day to practice (they have weeks) and if his student will be around when he has that big MI. Did anyone else in medic school have a similar experience? Any advice?

EMS is one of few professions whose diversity most closely mirrors the diversity of the communities it serves. However, where do you think EMS personnel stand in general and in relation to other professions on the issue of tolerance towards working peers (not patients) of other ethnicities, faiths, sexual orientations, etc?

I can't forget the dozens of times I've picked up a nursing home patient for private transfer and while flipping through their paperwork in the back of my truck getting their information for my report, I see that they're positive for MDRTB (multidrug resistant TB) and/or MRSA. I love it that they aren't on isolation in the nursing home, no one told us they had TB or MRSA (if they told us anything at all...'they're not my patient'), and now I have to file exposure paperwork, get another PPD test on my day off, drive back to the doctors office to get it read, and hope for the best. So much for The Ryan White CARE Act.

And I love the 'full arrest' calls I get to the nursing homes only to find two to three RNs making two to three times as much as I do pounding on the chest of a very awake, very alert patient.

I have a nursing home horror story! The other night the entire EMS system of our county was wrapped up in transporting patients on vents from a nursing home to the hospital during a power outage. Why the nursing homes had no generators with 8 patients on vents, I don't know, but the nursing staff at the nursing home just made it worse. There weren't enough BVMs to go around, which meant some patients weren't being ventilated at all and were cyanotic (pockets masks?). Those patients being ventilated with BVMs weren't being ventilated adequately. No reports from the nursing staff, no one directing us to the rooms of patients on vents, no help loading patients, nothing. We had no preplanning for this type of incident because we didn't even know the nursing home was allowed to have patients on vents! The chaos didn't end there. We were unloading on the ramp of the ED when the ED nurses (who have never met us at the door before) walked out and told us we had to 'go somewhere else'. No explanation, just that there was no more room. A huge COBRA violation to 'divert' an ambulance in your parking lot. If they couldn't take us, the MD should of walked out and met the ambulance, looked over the patient, taken an oral report, and handed the Paramedic a signed transfer form to take them 2 miles down the road to the next hospital. We got on the radio and called the ED on the taped radio frequency. We made them broadcast on the radio system that we were being diverted from the ambulance bay. If EMTs and Paramedics had the union representation and lobbying efforts that nurses have, we would be making more, regardless of how professional or educated we were, because in my opinion RNs aren't always that professional (and can be downright dangerous), but they still make the big bucks.

Open up a free Flickr account (free Yahoo! account) and use Flickr Uploadr to batch-upload your photos. Those of us which don't have Windows or that specific plugin can won't have a problem and you can share those photos too.

Wounded troops breathing easier, thanks to lung device German-made Novalung now found in Air Force pulmonary emergency team's kit By Ben Murray, Stars and Stripes Mideast edition, Monday, July 31, 2006 Sixteen months after Lance Cpl. Joshua Mishoe nearly drowned in his Humvee in a canal in Iraq, he�s finally starting to breathe better. He can walk short distances around his Florida home without getting out of breath and no longer needs supplemental oxygen at night, his mother said. Improvement is slow, but it�s a far cry from where he was last March when he was lying in Landstuhl Regional Medical Center in Germany, his lungs steadily failing him, his chances of survival getting worse. �He was dying,� said his mother, Julie Mishoe. To save his life, military doctors looked outside their normal arsenal of medical tools and found something that would not only keep Joshua Mishoe alive, but within two months would help revive three other servicemembers. Called an interventional lung assist and made by a German company called Novalung, the device is now part of the inventory a special Air Force pulmonary emergency team takes to Iraq when critical lung patients need aid. But using it also placed doctors in the cross hairs of an investigation by the Office of the Surgeon General of the Army because the Novalung machine hadn�t made its way through the lengthy American regulations process required to approve medical devices for use. http://www.stripes.com/article.asp?section...p;article=39016

[The Georgia] DHR Seeks Public Comment on Initial Licensing of Emergency Medical Services Personnel administrative RULE 290-5-30-.12 In a cooperative venture with the Department of Corrections, the DHR Division of Public Health, Office of Emergency Medical Services proposes a pilot program to grant a restricted EMS license to certain classes of inmates that complete an approved EMS education and examination course. Restricted licenses would enable a limited number of persons to work in communities on licensed first responder vehicles under the control and supervision of local community partners. Here you will find the Notice of Termination of Rulemaking Proceeding. http://health.state.ga.us/programs/ems/index.asp So the State of Georgia is now subsidizing EMT education for convicted felons, how does that work? How is that right for law-abiding citizens who must pay out-of-pocket for their EMT education? But beyong questions of flooding the job market with more EMTs, Georgia is a National Registry state, you cannot hold a National Registry certification with a felony conviction, am I right?

I really like it. And despite the errors I see, I enjoy sharing it with family and friends because it gives them some idea of what I do and the challenges we face. I'm not a prude.

It's all about protocols, but it's also up to the medic to take the initiative in carrying out those protocols. I know many medics who would just assume get the patient to the ER quicker than actually call for orders and begin definitive treatment in the field. How many medics actually contact poison control while still on-scene of a poisoning or haz mat incident? While en route? How many leave it up to the ED? I remember one instance in which a patient arrived in the ED slathered in mayonnaise after a haz mat exposure. The ED physicians were furious, however the Paramedics had been instructed to do so by Poison Control when they called from the scene. And it saved the patients life. Just yesterday I began a thread in the main EMS Discussion forum on administering 30 - 60 ml of ethanol for a methanol or ethylene glycol poisoning. Are you up to the challenge of giving a patient report to the ED MD and then requesting orders to administer a shot of vodka or whiskey en route?

Have you ever administered Ethanol (standard dose 30 - 60ml of 80 proof) for a Methanol or Ethylene Glycol poisoning? I know most hospital pharmacies carry a range of alcoholic beverages, but does your ambulance carry a small amount in your drug box? Is it something you think your service should carry? If not, does your service carry fomepizole? To those who have never heard of this before, ethanol has a higher affinity for the metabolities that convert methanol and ethylene glycol to more toxic substances, such as formaldehyde, and formic acid (inducing massive metabolic acidosis). Article 1 Article 2 Article 3

Good point. Maybe decent health education doesn't exist out there. We're all familiar with the dismal sex education teens are recieiving (at school or at home, just look at the STD and teen pregnancy rates). I am aware of programs in my city and others which train barbers to check blood pressures and church-based health clinics (which definitely reach into the African-American, Hispanic, and Asian-American communties, who are overwhelming more socially-centered around churches than Whites).

Wow, how insightful :roll: . Easy for someone from Ontario to say, which is what, 80-90% caucasian I believe? I also think Ontario has the highest per-capita-income of all the Canadian provinces. While my city is immediately surrounded by the 1st, 15th, 18th, and 21st most wealthy cities in Georgia (based on per capita income), my response area ranks 180th in the state. Georgia is the 24th most wealthy state in the union, but that doesn't mean much, considering it's the largest state East of the Mississippi it should be much higher. My city is also 38% Caucasian.

As an EMT (and Paramedic student), I work with all kinds of people all day long. Yet most of what I see is people who have exacerbated their medical problems through neglect of their health and failure to comply with their prescribed treatment. Simple things, like taking a daily walk, filling their blood pressure medications, or checking their blood sugar seem to be beyond these people. Very few of my patients pay full price for their medication, most get their medication and supplies free through Medicaid and Medicare. Yet they continue to neglect their health until they require a costly ambulance ride, ER visit, and hospital admission. Costly, for the taxpayers that is. (And if the responsibility does all on them, it still won't be paid and it doesn't matter that it might negatively affect their credit, you don't need credit if you're going to live in Section 8-subsidized housing your entire life). Most of the projects in my city have their own free health clinics within a mile! In my opinion, these people are criminally abusing the system. I'm not greedy. I'm not a conservative who thinks the answer to every problem is to lower taxes and "downsize the government". In fact, I would have no problem with how much I pay in taxes if it went to the right places, like universal preventative healthcare that people comply with, alternative energy research, or an AIDS vaccine. But it's hard to be compassionate for people who have no compassion for themselves. Do they not realize that they are killing themselves? And I can't help but say it, most of these patients are African-American, who are more prone to certain types of heart disease, diabetes, and cancer than any other demographic, it's a fact. When are people going to start taking better care of themselves? When are people going to take charge of their lives, on the most basic fundamental level as their own health? Should non-compliant patients lose their state benefits? Should people who skip out on paying for avoidable hospital visits be arrested? All I know is that I work hard every week for my healthcare benefits, food, and housing (and can afford little else). I try to take care of myself, my property, and my belongings. And I provide free transportation for dozens of people who abuse the system time and time again, and it's my fault, because I'm white, "middle class", and went to college. Anyone else feel like I do?

Eat and eat a lot! But stear clear of junk/fast food: stick to pasta, veggies, protein (meat/soy), and rice for long-term energy, fruit and energy bars for quick fixes if you need them (this means you may need to plan your meals ahead and pack them). Stay away from coffee and other caffeine, the constant up and down of caffeine and sugar will wear you out. A little green tea can help in the beginning, but I don't recommend indulging a caffeine addiction. Purchase dark curtains for your room, educate your family/roommates about being quiet after your night shifts. Do you exercise? If not, start. Pick up some 1mg Melatonin (now comes sub-lingually) to help you get to sleep after those night ships, believe me, it will be harder than you think. Also make sure you give yourself time after you get off to wind down, read, watch TV, etc.

A couple reasons I'm just going to smile and nod...best pay in the city, the only service with 24-hour shifts AND bunks to sleep in, and I just put in my two weeks at that awful job as a tech at the hospital, so I'm kinda scrambling. They'll also work around Medic school. Maybe they just don't have any other way to test EMTs and Paramedics, I would hope they would take into consideration any lack of fire experience. A decent EMT-I or Paramedic would do fine with the math on the test (GPM or mg/ml, it's high school math) and well enough on the reading comprehension. As for the fire suppression stuff...who knows. I think what it really discriminates against is people who are bad at tests! I'm more worried about being able to strike a block of wood 130 times with a 10-lb sledgehammer after a 12-hour shift in the ED on Saturday morning at 8am. I've seen a few of the EMTs working for that service (and others) who are busting 450lb easily or hovering at 90lb (members of the fairer sex) deliver us patients at the ED, so how hard can the physical agility test be?

Yes, I did apply at a fire department, but for a job as an EMT and only an EMT. As far as I understand, some of their firefighters are EMTs but most of ambulance crew members (EMTs and Medics which work only on the ambulances) are not firefighters, get what I mean? But maybe they are looking for cross-train. I didn't answer any advert in particular. My paramedic instructor mentioned they were hiring EMTs so I dropped in one day and applied, she's not fire, so I don't think she would recommend it if it was. I was asked to come in for a test, I asked if it was an EMT skills exam and he said no, so I figured it was a personality test.

Bird-flu TV movie has a scary vision The producers of "Fatal Contact" say science supports their script. Though some experts praise certain aspects, others say the film may confuse viewers. By Andrew Bridges Associated Press WASHINGTON - Bodies piling up so quickly it takes dump trucks to haul them away. Barbed wire to keep whole neighborhoods quarantined. It's Hollywood's version of bird flu, a blur of fact and fiction that some scientists say could confuse the public. Fatal Contact: Bird Flu in America, an ABC made-for-television movie, airs May 9, just as scientists are to begin testing of wild birds in Alaska that could herald the arrival of bird flu in North America. Scientists fear the bird flu virus could evolve so it could be passed from human to human, sparking a global pandemic. The two-hour movie plays up that notion to the fullest, with a running ticker that tallies tens of millions of victims worldwide. In one scene, the bodies are thrown on a pyre, like the carcasses of cows torched in the 2001 foot-and-mouth disease outbreak in Britain. The producers of the movie, from the writer of 2002's Atomic Twister, bill their work as a "thinking man's disaster film." "We call this a plausible, worst-case scenario. This could actually happen. It may not be this bad but it could be this bad. The reason to portray it this way is to kind of give a wake-up call to everyone, and this is something we shouldn't ignore and we should be as prepared as we should be," said Diana Kerew, one of the movie's executive producers. Bird flu expert Michael Osterholm said the movie realistically portrays the shortages of goods and services, and some of the ensuing panic, that could occur in a pandemic. But Osterholm frets the blurring of information and entertainment could do the public a disservice, and he said he hopes to arrange a conference call with television critics before the movie airs to set the record straight. He singled out for criticism how the movie shows Virginia officials using barbed wire to fence off and quarantine entire neighborhoods. "This is far too important an issue to create further confusion in the public's mind," said Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota. For the record, a spokesman for Virginia Gov. Tim Kaine said the commonwealth has no plans to roll out cyclone fences and barbed wire. "We haven't done that since, oh, the '50s," joked Kevin Hall. Fatal Contact begins in China, where - in the movie - the bird flu virus has mutated to the point where it's being passed human to human. It's only when an American businessman - "patient zero" - prepares to catch a flight out of Hong Kong, after crossing paths with an infected factory worker, that the global pandemic really gets started. Playing supporting roles are a wadded-up cocktail napkin, stuffed olive and an apparently less-than-sterile martini. The movie suggests the Richmond, Va., businessman infects several dozen airline passengers, who scatter around the globe. Viewers may never accept a hot towel from a flight attendant again. Health officials catch on quickly, but apparently are slow to tell the rest of us. At least two weeks pass before the president bothers to let on that it's the 1918 flu pandemic all over again. That apparently didn't faze the dozen or so Department of Health and Human Services officials who screened the film at the request of the Associated Press. Bruce Gellin, director of the National Vaccine Program office, praised the movie's timeliness in raising public awareness of bird flu, as well as its portrayal of "a number of potentially realistic scenarios." Those include the limited availability of antiviral medicines in a pandemic, the months it could take to develop an effective vaccine, and in turn how the United States could be dependent on other countries - yes, that means France - to provide vaccine. The movie's emphasis on planning also won kudos from the department. "There's a lot of science in the movie about why this would be scary if this were to arrive. Unfortunately, in our scenario, it is too late to stop the spread and that is what is being predicted by scientists if this were to occur," said Judith Verno, who produced the movie with Kerew for Sony Pictures Television.

I got a big eye-opener into how EMS is still the red-headed step-child of Fire this afternoon when I went in for an interview for an EMT position and ended up sitting for a fire fighting tactics exam. I am lucky enough to have some experience in this field and I passed, but what about EMTs and Paramedics with no fire experience? On Saturday I have a physical agility exam, again for an EMT position, that includes hitting a block of wood 130 times with a 10-pound sledgehammer, rolling and unrolling fire hose, opening and closing fire hydrants, donning SCBA and hauling a dummy. As an EMT, I hope I never need to drag anyone anywhere. I'm a good 6'2", 185lbs, I've passed these physical agility exams before, but for fire jobs, not for EMT jobs, what gives? Does anyone else have any experience with this? How standard is it for fire department to require their EMTs (who will never fight fire) to pass fire tactics exams?

$8.87 USD per hour plus shift (pm and weekend) differentials as an EMT-B/Tech in an ER. Also full benefits for about $35 a week. Unfortunately I am having to drop from part-time benefited (requires 36-hours per week) to part-time casual in order to complete my Paramedic clinicals. Our ED employs Paramedics to treat low-acuity patients under the supervision of an NP or PA. But no one gets the pay or perks (bonuses and overtime) of an RN, which is why I am reluctantly going to tackle that next. PA school sounds nice, but just lacks the flexibility of an RN with travel opportunities and scheduling.

Yes, my resume has been combed over and refined by a couple hands, including people who actually do some hiring of their own. When I mentioned that the AMR recruiter in California sent me a letter telling me things were missing, they were referring to things such as copies of my ACLS, PHTLS, and PALS license, my CA drivers license and such. But my intention was just to get a heads up of a recruiter, not to actually apply, I guess those cover letters don't matter all that much after all.

So I faxed my resume and a completed application around to a few AMR outfits with a cover letter introducing myself, my experience, and that I will be graduating Paramedic school in 5 months and will be looking nation-wide for employment. I stated in my letter and it was my intention to get my resume on a few desks. I heard back from one outfit, one sent me a detailed application, and another sent me a letter telling me I left out this, this, and that, out of my application as if they didn't even read it. I know there are a lot of employment questions on this forum, maybe someone could compile a guide to EMS employment one day. My question is how do I plan ahead for a job after graduation? I see this and that city are holding exams, but what am I supposed to do in the mean time, how do I make money and pay bills while taking off time to fly around the country to sit for exams? I'd like to get out of town but what are some things I can do to plan ahead, that is, besides passing my course, the NREMT exam, and wrapping up my clinicals?

I'm an EMT-B (currently earning my Paramedic certification). I work in the ED, functioning as a nursing assistant/LPN. I work 'part time' 36-hours per week benefited at $8.87 per hour. I do many things street EMTs do not do: start IVs, take and interpret 12-leads, even administer drugs. It's nice, my role in the ED continues to expand as I work through my Paramedic cirriculum and gain new skills. Our ED also utilizes Paramedics from 11am - 11pm for medical cases (cold, flu, simple trauma) under a P.A. or N.P. We are a very progressive ED in that respect, we owe it in part to the fact our Director is a former EMT and Paramedic himself and a fair amount of our Physicians began as EMTs or Paramedics. EMTs and Paramedics are often sought after for their phlebotomy skills. Unfortunately outside of emergency medicine, an EMT-I holds only the equivalent of an advanced CNA.

Nurses aren't happy with Grey Anatomy or House, M.D. They both show doctors doing things nurses would normally attend to, even in the most progressive hosptials. These shows also portray nursing staff and allied healthcare as dumb and/or obnoxious, as we saw last night. I love House, M.D., but on more than once occasion, House has insulted Paramedics. In one instance, when the medic was giving his report in the ED, House effectively told him to shut up and told him that he should of stayed in school. I know House's character is intended to be caustic, but what people see on TV determines a lot of what they think about the real thing...as unfortunate as that is.