asrnj77

Not sure why you think he needs the intense OPSEC...they also printed the name of his supervisor. SWAT team members are not undercover detectives (usually) so having their names in the paper probably isn't giving away much. Other than now the local hoodlums will pop the trunk of his crown vic in the driveway and take his AR, MP5, body armor and 50 mags I also saw that you said you don't see a paramedic doing ALS duties until the scene is secured. Well I believe that is the point of the tactical medic. They get some training in team movement, safety, and accept the risk of working in a hostile environment. What about the active shooter scenario - You have 1 maybe more shooters in a public school (guess it could be private too and the team moves in - Officers prepare to move into a classroom and one officer takes a groin shot possibly nicking the femoral. Could another member apply a tq or pressure? Yes, but now you have one guy wounded and 1 or more (shooting team members) treating him. If you have a dedicated team medic - they can provide care while the members address the problem at hand - the shooter. A lot of SWAT team medics spend them time addressing non-traumatic injuries like training injuries, dehydration, jock itch, and checking vitals before PT drills. Of course you could have a civilian medic doing this but the "team medic" or the dedicated "tactical medic" develops a bond between themselves and the team. Trust plays a big role and if they feel that you have taken the initiative to learn some tactical training it may further the team as a whole.

http://www.diabetes.org/uedocuments/CDL080105.pr.pdf Interesting article about the SAFETEA-LU act where insulin dependent diabetics are now allowed to get CDL's for interstate trucking. (above) Another little tidbit relating to diabetic paramedics below: On February 3, 2000, Mr. Michael Day filed a charge with the EEOC, charge No. 281 A0 0442, alleging that North Kansas City discriminated against him on the basis of disability in violation of the ADA. Specifically, Mr. Day alleges that he met or exceeded the qualifications for a firefighter/paramedic vacancy at the North Kansas City Fire Department but he was rejected for the position because he has insulin-dependent diabetes. The undisputed facts show that at the end of the testing and interview process Mr. Day was the top-ranked applicant and had been approved for employment as a firefighter/paramedic by North Kansas City's own medical examiner. At the time he applied, Mr. Day was working as a firefighter/paramedic at the neighboring South Metro Fire Department. On March 23, 2000, the EEOC issued its determination that there was reasonable cause to believe that the North Kansas City Fire Department had violated the ADA. The EEOC found that the North Kansas City Fire Department had violated the ADA by requiring Mr. Day to undergo a medical examination prior to a conditional offer of employment and that it also failed to hire Mr. Day because of his disability. After conciliation efforts between the North Kansas City and the EEOC failed, the EEOC referred Mr. Day's charge to the Department of Justice with a recommendation that it file suit. The ADA applies to North Kansas City because it is a person within the meaning of 42 U.S.C. § 12111(7) and an employer within the meaning of 42 U.S.C. § 12111(5)(a). The United States alleges that North Kansas City violated Title I of the ADA by failing to hire Mr. Day, a qualified individual with a disability, based upon his disability, Insulin Dependent Diabetes. Lastly this one relates to the infamous California "Ambulance Driver Certificate" This is an excerpt that I had to retype so please excuse the errors. "At a hearing before Administrative Law Judge Judith Castro, Larabee argued that denying Garrison a certificate constituted unlawful discrimination in violation of both state and federal law. The Supreme Court recently ruled that each person must be looked at individually to decide if he or she has a disability. We argued that this same rationale applied to determine if an individual was capable of performing a given job. Sarah Garrison, like anyone else, should be treated as an individual. Judge Castro who was not knowledgable about diabetes, listened to Garrison explain how she injected insulin and how that insulin, along with good nutrition, helped to keep her diabetes in control. The hearing itself lasted far longer than expected, but before they left the judge shook hands with Sarah and gave her a big smile, Larabee recalls. Three months later on December 12th, Garrison received her second letter from the DMV. This one was cause for celebration. The DMV admitted that its refusal to issue an Ambulance Driver Certificate "is not warranted".

You are partially correct but a little misguided. A department could disqualify a diabetic after their doctors have evaluated said diabetic. This is reasonable and makes sense but having a blanket ban that excludes all diabetics without an evaluation is discrimination and is not protected. The only people that don't have to follow EEO (don't get me started here :twisted: ) is the military. They have to provide EEO protection to diabetics that are already enlisted/officers but do not have to accept any diabetic applicants. This will change one day - probably with more advanced pump/glucose monitor functions that are about 5 years from FDA approval.

Well with that attitude why would African Americans sue to play on a particular golf course? It's just a hobby, right? To me this is discrimination and I will challenge it when I can. I don't take something from an Agency because it is convenient for them, I think it needs to be fair. To me it is discrimination cut and dry. You may not feel that way although you acknowledge knowing good diabetic medics. Why can't they have every reasonable opportunity available to them? As far as volunteers....in Northern Virginia over 500,000 people (2000 census) were covered by volunteers during the evening. The paid guys work daytime 12 hour and shifts and night VOLUNTEERS work 6pm to 6am. Without the volunteers people over a half million people would be up a creek. This includes Loudoun County, VA, which was ranked the wealthiest county in the United States this year.

Just getting back to original topic at hand, online med schools, which I think I brought up, are new and the word isn't out yet...I believe that at this stage it is the Excelsior College of M.D.'s. Excelsior produces some quality nurses but any nurse that went to traditional school is going to frown upon it. It's a perception that people feel it's the "easier" way to get an RN. I don't think it is easier, perhaps more convienient...nobody wants to feel that they broke the asses doing something and their counterpart is taking tests at starbucks Like I said in the beginning...if you don't mind a low on the totem pole residency and the quality of education allows you to pass the UMLE..then what's the big deal? I don't believe you will ever hear a traditional MD or traditional med student have anything nice to say about an online MD. Both of those schools allow you to talk to graduates. I would seek them out and ask them how it's been going and if they would do it all over again. Oceania alone is $120,000 for the MD with no student loans (They have payment plans where you pay $1500 a month though). It's big bucks and not something I would jump into lightly but in the end you are a doctor - plain and simple.

You must pass all the USMLE exams (which you are eligible to do) and then it is up to the state. But even if your state didn't allow it you could get licensed in another state and work in your state via the federal government. The toughest part about these schools would be getting residencies...you'll be low on the list and might be pushed into proctology in Northern Alaska.

I am also a type 1 and I had to get a lawyer to get on my volunteer squad. The lawyer and the rep from the American Diabetes Association informed the personnel office (The volleys are same personnel office as paid members) that what they were doing was illegal. Then they came out to me and said "Oh we thought you wanted to be a firefighter...oh a medic..that's fine". They went on to tell me that I couldn't be a ff because my insulin pump might melt....of course as a ff there is a chance that my face might melt too but that never seemed to stop anybody from getting hired. Either way they are still wrong about a blanket ban on diabetic firefighters but I left that fight alone for now. I am also in law enforcement and everybody wants to say what if your sugar gets low while you are arresting somebody...well then I didn't check it properly during the day. The benefit of a pump is that you don't have to eat at certain times during the day like with regular insulin shots. My pump uses humalog and is set that if I didn't eat at all, I would be fine (albeit hungry...). At the same time I feel your pain but driving the bus actually sucks and if they didn't want me to do it, I would be fine with that. There is a story that may shed some hope for you..it's from Diabetes Forecast magazine 9/2001 and the legal department at ADA can send it to you. It's about Sarah Garrison and her lawyer Dale Larabee whom successfully challenged the California courts and DMV to allow her to obtain the license she needed to drive an ambulance with type 1 so that she could obtain her paramedic certification. Highly recomend getting it because it sounds identical to your situation. It's a litigious society....take advantage of it.

You don't need health care experience for a PA program (although it certainly helps). You need undergraduate bio/chem/physics. But either way it's not distance taught. If you really want to go out on a limb and money is no issue - Oceaniamed.org in Samoa and (IUHS.edu) International University of the Health Sciences in St. Kitts allow you to work towards your MD from the convenience of home. You do the didactic portions online and clinicals in a participating hospital. Many people hate this and say "who wants an internet MD?" but if you can swing it ($$$$) and get licensed in your state...who cares what people say (I think you learn so much more hands on and I am not as concerned whether a doctor sat in a classroom with 200 other students listening to a neurochemistry lecture or watched it online) http://www.asph.org/UserFiles/SchoolMatrix%20Final04.pdf lists some internet provided MPH degrees

All records of minors are sealed so they could not see that a criminal charge was filed. The problem will be on the driving record. You can expunge certain driving records but it may be up to ten years. Also like others have said it depends on whose hiring. Baltimore City Police Department requires an applicant to wait until 5 years after a DWI. Alaska Police Standards allow up to three DWI's in ten years for applicants. Of course you aren't looking to be a cop but it's all public safety. Dropping out of an EMT course that is less than 150 hours is ridiculous. Stick with the program. I don't think the EMT trainee was driving an ambulance or coming to save anybody for that matter. I've seen EMT's that I wouldn't want coming to save me sober.

National Registry has two "I' exams 85 and 99. Study for 85 and you'll fail 99. Study for 99 and you won't grasp all the material and waste your time. Mosby makes a book to review for both specific tests. Even though the exams are on the computer now, I don't believe they are adaptive. Meaning your friends will have to answer all questions. They don't provide a score either - it's a letter in the mail that says PASS or FAIL

This is certainly a topic that you want to use the search feature for. It has been discussed pretty heavily. Most degrees for paramedics are associates degrees if you wanted a bachelors degree, most programs use the associates and then give you managerial and supervisory education along with some general education requirements. IMO - University of Florida has a good online program. I haven't done it but got some info and it looks squared away.

Cost of living is high unless you commute 40+ min but they get paid pretty decent (starting in mid forties)....the medics I know agree that its messed up but they love the action. These people like treating GSW more than broken fingers. So the ones I know trade action over the problems they have..(new medical director every year and lack of personnel). I guess its what you make of it....but just a side note - Alexandria, VA has single role medics as well. They don't hire as often but that's an option if you wanted to be in the area.

Tactical medic courses are bountiful.....just google "tactical emt" and you'll find hundreds of classes....just pick one close to NY.

I know the money situation has been covered but if you really want more money then there are other places. In Fairfax County, Virginia they have firefighter/medics that have been here 10 years making over 90k. Plus they work 24hr shifts so basically they have so much free time that they end up with an additional job making even more money...of course most people don't get into the profession for the money but if its really an issue then I say jump ship. Many departments in California are making big bucks too...I know cost of living is high but....

not sure why this would be alarming....the FAM (federal air marsal) program is trying to get a lot of FAMs trained as EMT-B's. The problem though is that they don't really want them to blow their cover on a twisted ankle patient...its pretty much for plug and play knife/penetrating trauma wounds to crew/pilot/each other. If that was an air marshal asking its probably just because he is interested and ACLS is a "cool" buzzword

The Army has been teaching NREMT-B in a month. The instructors though told me that they have been having a pretty high rate of failure for first time test takers on National Registry. The Army then teaches CMAST (combat medic advanced skills training) in a week. This replaced the former TC3. So it's very possible to merge a CLS/EMT-B course in a month. I kinda thought Navy Corpsmen did medic work for the Marines? Is this like a backup medic position or for smaller units?

Well in response to paramagic14 I can understand why most people would want to do it...I mean pretty much its to wear the ninja or jungle uniform and casually mention that you are part of a tactical team. There really isn't anything wrong with that...thats why police officers join a tactical team...they want the adrenaline rush and the prestige that comes with the title. But there are a ton of "tactical" medics out there....if you are not already a police officer you will not have a weapon...so you will not be entering a building...you will be out on the perimeter staging until called upon (the famous "Medic Up!"). If you wanted to assist a big city....they use MD's as their tactical medics (check out Dallas SWAT tv show). Perhaps you could find a small town that will work with you..you would kinda assist each other. They could puff their chest out and say that they have a tactical team [-o< with a medic and all! As far as taking a course...it couldn't hurt. I say that any education is beneficial and something you learn in EMT-T ( a lot of scene safety - GSW treatments) could help you in a typical civilian situation. You could find a course for anywhere between $400 - $950 and they are everywhere. The only one you couldn't take is CONTOMS (need law efforcement association). Just google "tactical medic" and you'll find something.

Glucose..... last oral intake?

EMS 205 - Advanced Pathophysiology at Northern Virginia Community College uses a human cadaver.

My post was merely comparing the US model of a two-year focused Paramedic program and the supposed superior paramedic that evolves out of an American bachelors degree. I agree that paramedics would probably get more respect and maybe a little more money by requiring a baccalaureate degree. But I also believe that the current programs offered in the US are not the same as the European programs that are also being discussed. I also think that some people want more education associated with their careers because it validates them. I'm sure there are school teachers that believe all elementary school teachers should have EdD after their name. I think that would be fine and it shows that that individual teacher chose to get the maximum ammount of education they could for their career. But does that mean that an intelligent, thoughful, and insightful teacher can't exist without 7+ years of advanced education? Assuming that a paramedic in a two year program completes 60+ credits (in America), then what are the other 68 credits in? I'm sure some are more a&p but it also looks like EMS management, book keeping, employee welfare, government, literature, communications, etc. Yes they are nice to have but my bottom line is if they benefit direct patient care.

I believe there are 14 schools in the US that grant Bachelors degrees in EMS. Below are the listed requirements for GWU, Creighton, and University of Texas, respectively. I already have a bachelors degree and I am close to a masters. However I don't see these all inclusive paramedic bachelors degree programs that are being discussed. I'm all for somebody expanding their knowledge, and they should. But saying that a paramedic with a 4 year degree is a better provider than one with a two year degree is wrong. Program Description The EHS Program offers a Bachelor of Science in Emergency Health Services (BS - EHS), with a concentration in EMS Management. The BS in EHS is a total of 126 credit hours including at least 60 hours of lower division and general education, 15 hours of health science core courses, 39 hours of EHS professional studies, and 15 hours of upper division electives. The degree is designed to accommodate the busy and irregular schedules common in EMS, fire service, and other health professions. The health science core courses and the professional studies are all available on line from GW. Upper division electives are available on line, on campus, or in some cases by transfer. The student transferring 60 hours of lower division or an associate degree and 12 hours of upper division courses will have no required on campus attendance requirement. FIELDS OF STUDY You have several options for study. The Bachelor of Science in Emergency Medical Services (BSEMS) prepares students to be leaders and highly skilled professionals in the emergency health care field. The bachelor’s degree requires 128 semester hours of course work consisting of liberal arts core courses as well as 51 hours of paramedic course work. An Associate's degree (ASEMS) requiring 73 semester hours is also available. In addition to the liberal arts core, students can expect to complete a rigorous paramedic curriculum that incorporates clinical and field training at the area’s trauma centers and fire and rescue departments. The bachelor’s degree is also an excellent pre-med track. Our graduates regularly go on to medical school, nursing school, and graduate programs in EMS and public health administration. Students should seek advising early, and often, in order to schedule the courses necessary to fulfill the pre-med science requirements Texas Core Curriculum Component Areas and Requirements Credit Hours Communication (English rhetoric/composition) – ENGL 1301, ENGL 1302, ENGL 1311, ENGL 1312, ENGL 2311, ENGL 2314, ENGL 2315, or equivalent* Mathematics 3 hours in Algebra - MATH 1314 or higher3 hours in Statistics – MATH 1342, MATH 1442, MATH 2342, MATH 2442, or PSYC 2317, or equivalent Natural Sciences – Courses with prefixes BIOL, CHEM, GEOL, PHYS, HORT, or other natural sciences 9 Humanities & Visual and Performing ArtsMust include: 3 hours in visual/performing arts – Courses with prefixes ARTS, DANC, MUAP, MUEN, MUSI, DRAM, or equivalent 3 hours in “other,” including literature, philosophy, modern or classical language/literature, and cultural studies** 6 Social and Behavioral SciencesMust include: 6 hours in U.S. history – either HIST 1301& HIST 1302, or HIST 1301 & HIST hours in political science – GOVT 2301 & GOVT 2302, or GOVT 2301 & GOVT 2305, or GOVT 2301 & GOVT 2306, or GOVT 2305 & GOVT 2306. 3 hours in social/behavioral science – Courses with prefixes ANTH, ECON, CRIJ, GEOG, PSYC, SOCI, SOCW 15 Texas Law requires that students receiving a degree from a Texas university must have taken a Texas Government class.

I think that's a Benz...still ugly as sin though...

I think merely basing things on education is not the answer. You would have to justfy that a current paramedic who takes the "average" two year program is not going to be as good a medic as one that takes a 4 year program. Generally the first two years of a bachelors degree program are when you take your basic classes: Western Civ and English Lit and the like. I'm not as concerned with my Emergency responder knowing details of the War of 1812 as I am with knowledge of ICP. With regards to European EMS, I saw a guy get hit by a car in Rome and the guy lay crumpled in the street. When the doctor arrived he walked around for a minute and then went back and searched for some equipment, and then spoke with the nurse. This guy didn't appear concious and was in a position where I would not assume he had a definitive airway. The doctor did not put his hands on the patient for at least 2 minutes. I do not know the outcome but I was not overly impressed by what I saw.

One issue you may run into is that most RN programs are full time/day classes. Whereas you can still find paramedic programs that run at night. Granted I don't know what shift you work, but it may be an issue. Also I think its pretty unusual that you don't have any volunteer systems in your area. Volunteering sounds right up your alley...

"Bob (not his real name). EMT-I99 expired last year after 10 years. Took Basic with me and failed NR Cardiac twice (no certification right now)." I would be concerned that Bob's I/99 (as in 1999) expired after ten years :scratch: