asrnj77

Well you kind of answered your own question. The 120 hours is likely the minimum required by your state. They never factor in study time or prep time as it varies with the individual. You also increased the amount of clinicals and ride alongs. Like many professions a lot is learned on the job. A police officer is not proficient right out of the academy. They learn the basics in the academy and the "real" police work in the field just like a new EMT. You get the base line training in school and NR and many states have determined that 120hrs is enough base info for that skill set. This could be argued back and forth but just remember that the hours of actual experience in the field far outweighs classroom time.

Yeah I have reached out to some people. I may just have to buckle down and stop being lazy I need to spend some time with the 'ole powerpoint. I have taken practically every "tacti-kool" course out there. Some great, some not so great. This is more geared for operator/buddy aide. TQ, QuikClot, Sucking Chestwound, Airway control...

Certainly tragic and to be so young....I believe part of it is the allure that private contractors can present. I mean a local firefighter in Arkansas vs. private contractor in Iraq? Maybe 5 times the salary? Many also believe they will be safe because they will stay "on base". Certainly there is danger abound and safety can't be taken for granted. Especially over there

So I'm having problems locating a "train-the-trainer" type course. Basically I've been tasked with teaching my agency a 1-2 day "tactical first responder" course. I have a lot of ideas in my head but I would prefer to have somebody authorize me to use their instructional materials. I didn't want to make a powerpoint that is pieced together from other people's potentially copyrighted material. A lot of tactical medic companies aren't in the business of producing instructors but I have no intentions of teaching to anybody outside of my agency. I have been to CONTOMS, OEMS, CMAST, TCCC and Wilderness but like I said it would make my life easier to have a concise program already prepared with material. Basically immediate action treatment for the non-medical provider. Plus my co-workers always like a nifty little certificate that they can stick in their folder..please let me know if anybody has any ideas...thanks

Bang out one of those EMT-W that includes NR-Basic cert with a resume friendly Wilderness attachment (resume friendly debatable). They take a couple of weeks and you camp around the woods while getting the cert. With your experience I wouldn't sweat a basic course at all... [web:7492d10974]http://www.nols.edu/wmi/courses/wemt.shtml[/web:7492d10974] You can google more classes. I would avoid NY personally because they don't recognize National Registry and it makes transfering that much more difficult

Well you are right about the change in stance but I think it goes against what you are saying. The traditional method for facing a threat was the weaver stance which is basically blading yourself with your dominant foot back. They found that this opens the weak side arm pit (as you mentioned) to gsw. The new stance is to face the threat directly so your body armor can provide it's maximum level of effectiveness. The vests can be bought off ebay for relatively cheap. Sure they have expiration dates but they have found that a lot of the expiration dates are like those on medications....you can extend the life by a few years. There have been many studies on this....just look it up. Some fabrics like zytel have been recalled after failing an unusual amount of times so research your material as well. Basically they are hot and uncomfortable but if you get shot then that will be the day you wish you'd worn it. Personal decision...been discussed plenty before

Paramedic Shortage Eased Interesting article about how the metro DC area is recruiting medics. Even in some of the more rural jurisdictions starting pay can be 57k. I especially like when they call the paramedics "field doctors". Also keep in mind that I/99's and P's are called Paramedics in DC and Northern Virginia and the term refers to both in the article.

The card issue is irrelevant. As mentioned before, they have ground medical control. So you put the little headset on and speak with the md on the ground. They can't see what your little card says and the situation now calls for somebody to do what they are able to. If you tell the doctor that you are an EMT-B and don't know how to start a line but you think this person is having a stroke, then the doctor will authorize you to perform whatever they are comfortable with on their medical license. This may be 02 by non-rebreather and monitor. You can't expect a flight attendant to say "oh I see that you are a wilderness emt from Pennsylvania and since we are currently over some wilderness you can now go crazy with the furosemide and 16 gauge iv" Hopefully the most qualified person or group of people will volunteer and explain their level of ability to the medical control and they will take it from there.

How did this nurse know that he was "just drunk"? Did the nurse expect you to do labs on the scene? Unconscious patient....sounds like you did everything right. I guess you could have left him knocked out and come back the next to pick up the body when he aspirates vomit. A bac of .25 is a solid buzz but everybody is different...I label this guy a buzz kill for making them call 911

This is taken from the association of national park ranger newsletter - just thought it was relevant... "EMS Clinicals and Ride-Alongs — Unlike full-time EMTs and paramedics, most ranger/EMTs do not treat patients every day they go to work. Some work at parks that are busy year-round, such as Great Smoky Mountains and Shenandoah, and see their share of sick and injured people. But often, the ranger/EMT is able to transfer patient care to ambulance personnel within five minutes of arriving on scene. Plus, they frequently bear scene safety, traffic direction and accident investigation responsibilities. Others work at parks in remote settings where ambulance personnel may not have access to patients, such as Lake Mead and Glacier, in which cases the ranger/EMT usually is the primary care provider for extended durations. But oftentimes their EMS caseload is significant only during peak visitation periods, not year-round. We are committed to providing the highest quality of treatment to our patients. The best way to achieve this is to maintain our skills. In turn, the best way to do this is to treat patients often. So, we have a quandary: How do we maintain our perishable EMS skills, thereby ensuring our patients receive the highest quality of care? One answer lies in clinical rotations and ambulance ride-alongs. This means we immerse ourselves, several times a year if possible, into an environment where we are surrounded by full-time medical professionals, we observe them as they work, and we treat patients ourselves. Lots and lots of patients. There are five arrangements available to most ranger/EMTs. Of course, each is contingent on an approved agreement among supervisors, the cooperating entity and park medical directors. Emergency Room Clinicals. By far, spending time in a hospital ER is the most effective way to increase hands-on, face-to-face interaction with patients. Though not the best setting for improving field skills such as patient packaging, it cannot be surpassed in terms of patient volume and its wide spectrum of chief complaints, medical and trauma. Outstanding opportunities exist for conducting patient assessments (an imperative skill that is often glossed over), airway management, CPR and other procedures. For park medics, a 12-hour ER shift will usually yield six to 10 IVs and meds administrations. With every patient, lay a hand on their wrist, obtain vitals, listen to breath sounds and ask lots of questions. Spend time with patients and listen to them. Operating Room Clinicals. In many cases, rangers can augment their ER time with time spent in the hospital’s OR. The primary — and often only — procedure rangers will perform in the OR is endotracheal intubation, and this will be limited to parkmedics, paramedics and possibly intermediates with advanced airway management training. Additionally, the OR is a sterile setting, and rangers can learn much about sterile fields simply by observing OR personnel at work. Though the scope of skills covered in the OR is more narrow than that of the ER, its value to ranger/parkmedics is indispensable: In several hours’ time, one can perform maybe a half-dozen intubations. For most ranger/medics, it’ll take a year or more to do the same number in the field. Ground Ambulance Ride-Alongs. Second only to time in the ER in terms of overall value is time spent doing ride-alongs with a local ambulance service. Ranger/EMTs will not only contact a lot of patients, they’ll do so in a field environment, and they’ll usually be permitted to perform any skill they’re certified in. Additionally, they will acquire a fair amount of exposure to radio transmissions between paramedics and ER docs — again something most rangers do not do enough of. It’s amazing how much we can learn just by listening to the medic call in his or her patient assessment and to the physician’s questions and orders. Air Ambulance Ride-Alongs. For parks close enough to an aeromedical ambulance service, conducting ride-alongs on flight missions is another medium in which rangers can expand their EMS experience. Often rangers are limited strictly to observation. However, much can be learned from watching, especially considering most incidents requiring air evacuation are serious in nature, and flight personnel are often the best of the best. And as a bonus, rangers will further their helicopter experience, which only serves to strengthen us as well. Ski Patrol. Rangers volunteering as ski patrollers can also improve their EMS skills. Again, not all rangers work near ski areas, but for those who do, volunteering as a patroller provides an almost ideal setting, one that in many ways mimics some of the problems rangers face in backcountry EMS incidents, such as similar injuries, inclement weather, rugged terrain and possibly limited equipment. We can never provide care for too many patients, and each one we treat increases our experience level and confidence. We have a responsibility to ourselves and, to a greater degree, our patients to remain as skilled rescuers. The above efforts will help us emerge as more competent EMS providers. Our patients deserve that much." ~ Kevin Moses, Big South Fork

IMHO...starting lines is not very difficult....I've seen junkies on the street that can get IV access in their own neck....even in paramedic school you practice on some manikin arms then each other and then during clinicals in your rotations. Why not have Basics in rural areas that can quickly give d50 or narcan? Maybe the pharmacology isn't all there but if there was ever a case for cookbook medicine here it is - "He took three bags of heroin and now he is blue" Also in the Army NREMT-B's are trained in I/O access during CMAST. It's about an hours worth of training. This isn't going to be narcotics, acls drugs, etc. It is life saving, easier to dose medications. It is not a substitute for a paramedic...it is just enhancing the life saving capabilities of emergency medical technicians....I think this would work best in rural areas with sparse populations...just my opinion though

if for some reason the link doesn't work..just go manual www.cottage-grove.org/ems.htm

Cottage Grove, Minnesota read above...

IMHO....people like to start IVs because they feel like they are getting more or using their advanced medical training I feel that oral rehydration is the better way to go unless you can't keep it down...if you need vitamins drink some gookinaid or 50/50 gatorade h20 blend...

Something to consider...of course a ballistic vest can save your life but they also add an intense amount of trapped body heat so if you are a "hot" person expect to be 20 degrees warmer. (bear extra notice smelly/sweaty people) If you don't get it properly fitted it will ride up and choke you when you sit down or pinch your armpits. Puncture/stab resistant vests commonly used by correctional officers are hotter/thicker/less mobile than traditional vests. Again, it's a decision. If you want protection it's an excellent option but like everything else it has it's ups and downs. Lastly vests have "lifespans" so make sure to check the date printed on them when purchasing used ones. That being said, even though they may be expired many tests have shown them to still be effective.