firemedic78

-What do we expect...well for starters, I would like to see more accuracy! -Never seen radiation or Nuc Power realistically portrayed...of course not! Just like you don't see true lock picking...It's a security issue! But you can realistically portray what we do without risking security. -Anything helps people understand that we don't just drive the ambo...evidentally we all like to screw in the box too! That's a real good understanding of what we do! :roll: Now when people call for an ambulance, they'll be wondering if we cleaned up after our 'job'. So much for a clean/sterile environment for patient care. :roll: (i'm not slamming, just replying to your comments) i think most of us agree this show was poor in quality. It's a shame, but like etfink stated...this is a drama geared at normal folk. just my .02¢

](*,) all I can say is WOW!! :shock: Not sure who decided to check this show for accuracy! I'm guessing nobody. i was fortunate to only catch the last 20 minutes of this Horrible show. I don't know which i hate the most... 1-the fake strobe lights flashing everywhere, with most all apparatus onscene at the fire with halogens, 2- the chick being rescued (due to smoke inhalation) by the fireman with NO mask on, 3- the weak excuse for a master stream coming from the ladder truck, 4- the extremely poor attempt at resuscitating the chick from #2 ( did they stop bagging while intubated?? more than once!! I know they did after they shocked and got a sinus rhythm!) That should be taken off the air immediately and burned. And it should not be re-aired... EVER!! :pottytrain5:

](*,) all I can say is WOW!! :shock: Not sure who decided to check this show for accuracy! :scratch: I'm guessing nobody. i was fortunate to only catch the last 20 minutes of this Horrible show. I don't know which i hate the most... 1-the fake strobe lights flashing everywhere, with most all apparatus onscene at the fire with halogens, 2- the chick being rescued (due to smoke inhalation) by the fireman with NO mask on, 3- the weak excuse for a master stream coming from the ladder truck, 4- the extremely poor attempt at resuscitating the chick from #2 ( did they stop bagging while intubated?? more than once!! I know they did after they shocked and got a sinus rhythm!) That should be taken off the air immediately and burned. And it should not be re-aired... EVER!! :pottytrain5:

:banghead: Johnny Sicko!! :naka:

my research article was for a class i was taking. Credible? :dontknow: Well i guess it depends on your perception. My instructor seems to think i am credible, as do other medical professionals in my area who know me and who ride on my box with me. Our local ER/OR docs seem to agree. So you can be the judge. Here is the link to a related article, again showing 83% (granted it was only done on 95 people) IN Naloxone Article Yes, further studies DO need to be done, but this initial research shows great results and fewer needle sticks. Take it for what it's worth. As for fueling the fire as I 'have this great tendency to do.', I just bring up everyday events/comments that i hear or think about. As for proving my point (see EMT-Intermediates using Naloxone thread..) I did not set out to prove to the forum my perspective. I just brought up a question. And from the poll results, and some comments posted, other Intermediates DO administer the drug. As for Proving the necessity, the thread was split about 50/50 so we'll take that for what it's worth too and let it die. Hopefully this thread will not end up the same because it falls on the same lines...WHO should use it/should it be used. As for Paramedics getting more accidental needle sticks than basics...I am well aware of this point and you are correct. Paramedics are put into the situation more than a basic should. I never disputed that fact. However, when some paramedics bash EMT's for one reason or another (ie making a mistake), they need to step back and look at what they do wrong too. Nobody's perfect, and I challenge anyone to admit that they have never made a mistake. If anyone is that fool hearted, let him/her speak...I doubt anyone can claim this feat!

Ridryder911 wrote: I understand that point. Most of our blood is drawn within 5-8minutes prior to hitting the door at the ER, and we send them to the lab(via vacuum tube system) just after patient report is given. We label tubes ourselves to speed the process up, but can wait for the printed labels with barcode and patient info. Most times while the attendant medic/emt is giving report, the partner is handling this task. oh yeah, back on topic. All major trauma patients around here get IV with fluids. Typically LR @ TKO unless they need a bolus/challenge...Some give just NS @ TKO.

Dust wrote: So you're saying that pre-hospital delivery of Oxygen is an ALS drug? Because last I checked, you need a MD Rx to purchase oxygen for medical use, therefore it becomes a prescribed drug. And pharmacology deals with drugs...so... :roll: ...Oxygen should not be used by EMT Basics??? Because it is now an ALS drug, or so you're implying by your comment. Now back to the topic... I recently did a research article on IN Narcan administration and the resource i found stated that 83% of patients that rec'd the IN route came about with one dose, and did not require an IV. The article was actually about reducing needle sticks to 'Paramedics' because there are too many accidental sticks. :angel9: i'm going to keep this thread clean of bashing medics for sticking themselves- since some here rant and rave about being so much more educated then Basics and Intermediates...(guess they need to add more hours into the course- 'how not to stick yourself accidentally') To all you medics who haven't stuck yourself on the box...good job, keep safe! 8)

#-o Emergency Medical Tigger wrote: How dare you add sarcasm to this thread!! You are going to offend some of the Paragods here!! So i'll play a little song for them... :-({|= :grommit: Grommit sarcastically says, " I only want 'higher educated veterinarians' giving ME Narcan...not you undereducated vet techs!" Now that people are speaking up...those who are against this topic are trying to get it locked! :dontknow: Post on all ye who are in support! Those not...stop reading this thread and move on to trashing other threads! :violent2:

Is there a bonus for having a post with this many pages and having a poll still half/half? There seems to be more people (paramedics) voicing their NO vote and why they think it should be that way... but there still are that agree that haven't voiced their reasoning. :D/ on to page 15!! Gee, is there enough anger and hatred on this thread to make it to 20 :roll: .

:? may be a stupid question, but why don't most of yall get blood on the box? cost maybe? [-X Do the hospitals not want you to get blood for them? Here we (all local services) get blood on just about everyone that gets an IV. They almost strangle us if we don't have blood and have an IV...depending on the severity of the call of course! On patients not requiring fluids, we place a lock...otherwise just TKO'em.

Calm down Nate :evil: . This is what stops good relations between people in our profession...or until this crap stops, our trade :shock: . Back on Topic: I have heard of this before. Just two weeks ago we had 3 firefighters from Sweden come down and ride out with 4 different fire departments. Only 2 firefighters from here went over to Sweden. It's neat to hear the different techniques and lingo . I found out a city nearby, Clute, means 'Balls' in sweden! :twisted: that's good stuff right there!

i'd appreciate putting the correct person in your quotes. I did not make this comment!

:roll: I don't seem to recall saying that it was only an 8hr class, or that it didn't go over A&P of the systems affected by the drug. That goes back to some paramedics assuming they know it everything! You know exactly what goes on in these training classes, even though you haven't asked anything about it. As has been mentioned here on this thread, and should have been in all paramedic's pharmacology sections, Narcan administration given properly and in the correct dosage/time frame is more likely to help rather than hurt the patient. Can side effects happen that Intermediate NOT control...yes! However this is a very small majority of patients IF the drug is administered correctly. No paramedic can say that when given the proper amount/time that a majority of these patients have side effects that require immediate paramedic level skills/interventions! AND, as has been stated in various threads on this site, sometimes sarcastically, thats what ALS intercept is available for. :shock: what i think is really bad is that some paramedics that are fighting this thread and stating that Intermediates are crying for more drugs, skills, or whatever.... are hipocrites. Here's why: At some point, a group of paramedics did question adding skills and/or drug use for themselves. Why would they do this? To learn...and to be more valuable on the street. After a while, the MDs were convinced to give paramedics a bit more education and allow them to practice more skills/drug therapy. We know it wasn't a group of MD's that got together and decided to dump these skills on paramedics! They asked for it and they got it. Now the same principles are being attempted by some Intermediates who want to take another step in education and practice skills to be more valuable on the street. Nothing ever said that they weren't going to move on to paramedic, but not everyone starts at age 18 going to basic and goes straight through paramedic in a few years (like one medic I know on this site). Most people i know want to get some street experience between each cert level so they can use that experience to help learn. So WHY are paramedics so against a learning process that they have gone through in the past??

all the comments about EMT-I's wanting to get access to 'more drugs' without higher education is the main focus for all the Paramedics on this thread. However, the number of hours right now does not include administration of Narcan. Therefore...if it was allowed, more training would need to be done!! WOW...more education! :shock: That means more hours of training. :roll: I just found out that a service that neigbors my city allows EMT-i's to administer Narcan with their protocols. This is because the med.director held a training class to 'EDUCATE' the Intermediates. And with all the problems that Paramedics are having in the news these days...what gives them the right to talk about how EMT-Is actions? How many of you paramedics have given 'paramedic drugs' for an unconcious unresponsive and get to the ER and find out later that a d-stick was 20? i hear about it quite often from ER docs all over. Paramedics treating the monitor, or not utilizing a basic skill...using the glucometer. So now I ask...after proper additional training by a medical director, what is wrong with Intermediates administering Narcan?

:roll: if i could only buy a clue as to why you read too far into a thread... I am not concerned with the seeking out the 'fastest way' to paramedic, or the whining of how many more skills without paramedic school. My question was a question of if intermediates should be able to use it. there are a lot of services that do...and a lot that do not. This was not a 'why can't i push more drugs and not go to paramedic school' thread, though you seem to read it that way. I am all for higher education. I am also in agreement that basics and intermediates don't have enough education yet to push most drugs, OR understand the effects behind it. However...under proper medical control, or paramedic authority, why shouldn't intermediates be allowed to push things. It takes 1 task off of the paramedic so he/she can begin the next task needed. i'm sure there are times when paramedics would let an intermediate do something above their scope, but LEGALLY they cannot. This is one of those items. i've been witness to this exact situation. A medic has told an intermediate that he can push it, but he refused because he didn't want to lose his patch. So then the medic had to stop what he was doing, and administer the narcan, then go back to his other duties of patient care. Now, before you read too far into this :roll: , yes he could have done all of it by himself (which he did), but it could have been a bit quicker had help been available.

that just goes to show your ignorance. you seem to ASSume that because Intermediates would like to have the availablility of a drug other than O2, that they don't want more education. I see this as highly incorrect. If you will look to another section of this site, you will see a topic about paramedic students uniting...in this thread there are people (some probably intermediates already) beginning their paramedic class. :roll: that seems to be 'more education'. And if you think that you are a supreme being because you think that way...oh well good thing you retired (or so you signature says).

quite a bit of response on this one... ok, first off let me clarify my question. I did not mean for everyone to assume that EMT-i's should have full autonomy to push naloxone, or for every unconscious/unresponsive patient that you come across. I fully understand/respect the anatomy and physiology aspect of concern with pushing drugs. And i am aware that detailed drug affects/effects down to a cellular level are not taught at most emt-b or emt-i levels. It was touched on in my intermediate class, but i in no way think i understand the full A&P of pharmacology! (just to set the record straight) The comments about side effects...we can stumble on any patient with tachycardia, arrhythmia's, seizures, nausea, hypotensive, etc. We are taught how to manage these patients to our certification level already. So pushing a few mgs of narcan to ease our job (see Titrated to effect) should be allowable under a paramedic order or medical control authority. There can be arguments either way on this one. On one side of the group you will have those who would rather just load-n-go and bag these patients. Then you will have the others who would rather bring them a little off the opiate and possible not have to bag patient all the way to the hospital...possibly risking a side effect such as tachycardia or hypotension, etc. so i suppose it's all a matter of preference as to what you would rather deal with. (or protocols of course) thanks for all the responses...

What do yall think about EMT intermediates being able to administer Noloxone to an overdose? From what I know about Narcan, there really aren't any side effects. And it doesn't have any adverse affects to persons not under opiate control. I know medics that give Narcan on anyone who looks like they overdosed on anything...not just opiates. Since EMT-I's already have IV access...why not a narcotic buster to help them. And with the overwhelming response to NI administration of Noloxone...why not basics too? I think that basics should be able to combitube people personally. Airway is a basic skill...combitube is a pretty simple tool. Makes sense to me. At any rate...what to you think about Narcan..... .... :?:

110% correct. We are complaining about low pay, not being considered a 'profession'...but we treat each other this way. He said, she said...EMT saves Paramedic, Paragod tells basic to drive and hook up some O2...etc You know, just my .02 :roll: ...maybe if we stopped and though about how 'professionals' acted, we would see that some of us don't set a 'professional' example for newbies and in the public eye. Not to mention the 'Paragods' needs to remember where he/she started. We all start from the ground and work our way up... We all had a question here and there too! How must effort does it take to answer a question while performing a task. Can you drive and talk? Can you talk and stick an IV? Do you talk to your patients while doing a task...why can't you answer a question to a newbie? don't assume the question is directed at you to "question your authority or knowledge"...maybe they just don't know! Play nice...we're all on the same team.

I agree to an extent. It's not right to spotlight professions as thieves...but they did advertise to a LOT of people. Maybe negatively though...

on the comment about ventilating a patient with a mis-placed tube in the esoph... since we're quoting 'National Standards', i might add that you typically have a partner who helps you in the process of intubation. I know...not always! However, per the N.R. skill sheet, you have a partner hyperventilate prior to tube insertion. Now...that being said...if you miss. You can have your partner prep another tube asap, and have the scope in the patients mouth about the same time. This should only take a few seconds. Maybe 30 at most. I know...30 seconds w/o air movement. However lets look at the alternative. 30 more seconds vs. 2 or 3 more attempts of 45seconds to a minute each! Which is the better option?

in the beginning of this thread it was mentioned that the reason we are getting crappy medics is because we are turning out basics that don't think. It was stated that all basics know is 15L NRB, wait for ALS. I have a problem with this comment. I don't know anyone who teaches that methodology! If it is required to have ALS respond, we teach (around here-tx) have ALS intercept or just haul butt to hospital. We don't tell anyone to just sit and wait for ALS! Second... with the problem regarding missed ETTs and re-intubations. I am sure it's not just taught here (around here-tx) that if you tube the esophagus, leave that tube and re-intubate with another ett tube...only 1 hole left right?? If you can't put 1 tube in 1 hole... :roll: Oh boy! Maybe I'm just talking out my arse...but I don't think i'm the only one who knows this technique! We should not have such a high rate of missed and re-intubations! just my .02

the transfer service i run with uses GPS, along with traffic maps online, to pick the closest and quickest truck to respond to calls. This can be a good system...However, when the dispatchers get power crazy they will call you and ask you why you went to this block and stopped when you were supposed to be posted at this block (usually the hospital). Well... i wanted to stop for something to drink prior to sitting in the truck at the hospital waiting for a call. But if i HAD asked first prior to stopping, she may or may not have let me stop anyway; depending on her mood! Then you have them calling asking for your ETA... :? WHAT?! You don't know where I am?? How is that possible? And to think...who has a map of what lies ahead traffic wise? Certainly not me. So really I should be asking them what my ETA will be. And the kicker, I was asked why i was turning onto a particular street, instead of going a different way. Both routes take about the same amount of time. My reply... :twisted: I'm drivin, your dispatchin; unless you can steer this thing from that console... ...and then there was silence the rest of the afternoon! Yes GPS can be a valuable tool...but it can also create havoc.

flight-lp close...Bay City is where it happened.

I had the "pleasure" of working for a private ambulance service which consisted of 90% HFD part-timers. A situation comes to mind when I was on the truck with a former HFD paramedic when we came upon an accident with a work truck, minivan, and commercial box truck. The driver of the minivan attempted to flag us down while he was still in his car. My partner proceeded to drive on by. When I questioned him about it, he proceeded to tell me that in Texas we did not have a duty to act and besides, it was in city limits-a fire truck and ambulance would be there shortly. Needless to say, I worked too hard for my certification to lose it and I quit.