CPhT

I got the call on Friday afternoon, and I'm going to my orientation/ training meeting tomorrow. Provided I pass my drug test (those things don't test for caffeine, do they?), I'll officially be a part time basic EMT for Community EMS, based out of Southfield.

That having been said, I've got the jitters. I haven't had a "first day" in a while, and even then, I knew 3/4 of the people I'd be working with.

Wish me luck, and more importantly, wish my coworkers luck.

Wow, lots of good points were raised, and many things I didn't even think of. I think I might just contact the organizers and tell them to start contacting the local EMS companies and asking if they can post a truck on scene, rather than volunteering my time. That way we're both covered medically and legally.

It looks like a really cool event. There are a few questions I would try to answer before getting involved.

Am I just going to be a guy that buys a ticket and brings my skills with me or am I going to offer my skills as an EMS provider?

If I offer as a provider does the law require me to have medical direction?

What level of trauma am I going to attend? If it is more than simple scrapes I think i would need the right gear?

That's kind of the things I would be talking about with the organizers. They don't charge for spectators, and they welcome volunteers, so it would probably be more of column B (offering my EMT services).

As for medical direction, that's the type of thing that I don't know the legality of. Am I just a guy putting band-aids on scrapes, or am I bound by the protocols of Detroit at that point? In my own mind, I don't see myself having any medications (no glucose, no ammonia, no O2, no aspirin), no airway kits, no BVM, no c-collar. I think I would primarily want to be there to have one person who's at least had SOME training, rather than 100 people who have watched House, MD and/or stayed at a Holiday Inn last night. Kind of a "central point of contact" for any medical issues.

Two-three times a year, a local group puts on a cool event called "Thunderdrome" in Northwest Detroit. The basic gist of the event is a bunch of people gathering at an abandoned velodrome (1000' concrete banked oval race track) and racing pit bikes, minibikes, mopeds, scooters, mountain bikes, "fixies", and commuter bikes. It's a legal event, with insurance and permits and such. However, over the last couple of events, I've noticed a disturbing lack of medical coverage. They have a small plastic case with neosporin and band-aids, but that is the extent of first aid available on scene.

My questions to the city dwellers are:

1. Would you, as a licensed but off-duty EMT, volunteer to provide any on-scene medical care, limited obviously to your provider level, but also with the stipulation that 911 will still be called, as needed?

2. What type of equipment would you bring with you? I'm really interested in doing this, but I have nothing aside from a small first-aid kit in my trunk, and my school gear (shears, stetho, BP cuff, CPR mask, and pen light). I don't want to feel like I'm carrying a portable trauma unit to this event, and I don't know if I can justify buying a wacker-kit just for 2-3 events per year.

3. The obvious one; liability. All racers have to sign a release form before being allowed to compete. However, if someone were to get hurt, and I was to provide care, what sort of liability does that open me up to? Does it open the organizers up to any liability if they allow me to provide care?

My main reason for asking, is that I have friends that attend this event. I also know quite a few of the racers. They all wear proper safety gear, but things happen. I'd hate to see someone go down and actually get hurt to the point where they need EMS care, then have to wait the 20-30 minute response times of Detroit EMS.

Your reward for putting up with my incessant nagging; a video from last year's event.

I forgot to add. The video above was taken at the April event, which had around 50 racers and probably 200 spectators. The September event had almost 200 racers and well over 1000 spectators.

Then again, I don't count the hipsters as people, so there are probably even more.

Wow, that's rough! I hate driving in Ohio, and it's gotta be even worse when you find out you drove there for nothing.

I'm kind of thinking about doing the March one, but we'll see if I have school or work duties then.

Just remember; when the shit hits the fan, you'll fall back on your training. Be confident in yourself and your answers. Get a good nights sleep, eat a good breakfast, leave yourself plenty of travel time. Just try to avoid any outside stress, that way the only thing weighing on your mind is the test itself.

Just remember the basic testing strategies and you'll do great.

Can you imagine a gym full of overweight people doing this and laughing. Gives a whole new meaning to all fat people being jolly.

Hey now, as a fatty, I almost take offense to that. You're lucky I'm tired from walking to get my coffee from the kitchen just now, or I'd shake my fist in anger at you.

Although, there is something damn funny about the mental picture of a dozen 400+lb'ers all in a line, doing deep-lunges while laughing like Santa.

Are you from Michigan by chance? I graduated from high school with a guy named Mike Ellis.

My guess would be that if your service doesn't have a policy, then you won't get this done. And it's a terribly dangerous thing to start waving the OSHA flag as they are God when you fall upon their radar and their fines most often start in the tens of thousands.

This statement right here is the truth.

One of our previous employees at the pharmacy thought that she was fired unjustly, and decided to "blow the whistle" on us to OSHA, the DEA, the FDA, and the State Dept of Health. Basically, they all took turns shutting down the pharmacy for inspections. In the end, we were doing things according to the books, with one exception from OSHA. I can't remember what the non-compliance was, but we were issued a warning, that if not corrected within the next 14 days, we were to be fined $10,000 for EVERY OCCURRENCE of the non-compliance. The problem was quickly resolved.

However, at our next team meeting, we were reminded that while we can't be fired for bringing something to the attention of OSHA, DEA, FDA, etc, things that cost the company money are bad. Why anyone would want to call OSHA on their own company, I don't know.

Work Practices

Q22. Can employees of an ambulance medical rescue service eat or drink inside the cab of the unit?

A22. Employees are allowed to eat and drink in an ambulance cab only if the employer has implemented procedures to permit employees to wash up and change contaminated clothing before entering the ambulance cab, has prohibited the consumption, handling, storage, and transport of food and drink in the rear of the vehicle, and has procedures to ensure that patients and contaminated materials remain behind the separating partition.

Q23. What alternatives are acceptable if soap and running water are not available for handwashing?

A23. Antiseptic hand cleansers in conjunction with clean cloth/paper towels or antiseptic towelettes are examples of acceptable alternatives to running water. However, when these types of alternatives are used, employees must wash their hands with soap and running water as soon as feasible. These alternatives are only acceptable at worksites where it is infeasible to provide soap and running water.

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=21010

Congrats Captain!

I'm 20, I have bifocal lenses... I have to say it kind of trips you up with stairs.. however, I tend to lose/break glasses quite frequently. Last year I went through 4 pairs. With my track record of losing/them breaking them, I don't want to spend THAT much on 1 pair of glasses.

If you don't mind me asking, how much are you spending on a pair of glasses now?

It seems that everytime they try to make it more easily understandable they frick it all up and make it harder to get anything done.

Amen to that. I was very, very confused by the whole situation. I actually called the Michigan EMS office when I was filing for my license last week to clear it up. The lady at the office told me "We wouldn't even deal with them, except it makes it easier for us. We don't have to administer our own test. We just use theirs, and you get to pay $70 extra." The good news is that now that I have my initial license, I can disregard the NREMT altogether and it won't affect my state license one bit.

I know I'll piss off a lot of people here, but I agree with you about the two stage thing. EMR should be rolled into EMT and AEMT should be rolled into Paramedic, making it two classes. BLS and ALS. Either you take a 2 year program so you can intubate, admin drugs, run 12 leads, etc... or you take 1 year and you can still drive the cool truck, but with less toys.

Sorry for the egress from the thread topic. You may now talk amongst yourselves again.

NREMT (The organization) is changing their titles for professionals, as well as changing the standards.

First Responder becomes Emergency Medical Responder (NREMR) By 2016

EMT-B becomes NREMT (by 2016)

EMT-I85 becomes Advanced EMT (NRAEMT) by 2016

EMT-I99 is eliminated, can transition to Paramedic (NRP) by 2019

EMT-P becomes NRP (next time you renew)

As to what's involved, as it's been mentioned, that is up to your state EMS office. I was told by my EMT instructor back in October that around 2013, Michigan will be redoing it's standards to match NREMT. The next section of my post is purely here-say, but this is what he mentioned will change;

NREMR:

"Stretcher fetcher"... basically all they will be allowed to do is CPR until a higher level cert arrives.

NREMT:

"Stretcher fetcher with a better truck"... CPR, AED, stop bleeding, light rescue, NO DRUG ADMINISTRATION except oxygen.

NRAEMT:

Supposedly will not exist in Michigan

NRP:

Higher scope of practice, more drugs in your toolbox, but longer training to get there. Paramedic in Michigan might be a mandatory Associate's program.

Again, those are things my instructor mentioned, and may/may not be the truth. Fine by me either way.

$1200 isn't all that bad, really. I know that my glasses I have as backup for my contacts were billed at over $800 to my insurance company. Granted, I got high-dollar frames, the lightweight lenses, all of the UV and scratch-proof coatings, warranties, etc. Those are single vision lenses though. I can't imagine what bi-focals or progressive lenses would have run in my case.

Congrats DFIB! Good job.

Good on you Eric...Your posts make it clear that EMS is going to be lucky to have you, much more so than you it....

I'd have bet a month's wages that you'd have no trouble...I'm really excited for you!

I'd say 'welcome to the family' but your intelligence and attitude made you part of the family long before the NR validated it.

Good on you Brother...

Dwayne

Wow... thanks! I can really only bow in humility around here. You guys are a wealth of knowledge. I'm hooked.

Congratulations amigo! I am glad that all the hard work you have invested payed off.

I just finished taking mine and now have to wait for results. One thing is sure How did they inform you? Do they update your status on you account or what?

When did it cut you off? I mean how many questions were you offered before you were cut off?

Thanks DFIB! I'm sure you did fine as well. My test cut off right at the 70 question minimum, so I had a good idea that I had passed before I even walked out. It was either that, or I bombed it beyond belief. As to the results, When you log in to the NREMT site, you'll have the option for "Check initial entry application status". It'll have your info there.

Is that nerves I detect? There is not a snowballs chance in hell that you didn't pass...but it is kinda fun to see you worried. I, we, all know the feeling...good on both of you..

How did you find the test? Was it what you expected?

Dwayne

I thought my test was nerve-wracking. In just about every standardized test I've taken, if there were four options, you'd typically have one or two which were obviously wrong, and the rest were acceptable, with only one of those being the MOST correct. With my test, it seemed like a vast majority of the questions had ALL acceptable answers. In my ideal world, I'd like to think they were trying to test our critical thinking and EMT-abilities rather than our test taking and memorization skills.

The part that I thought was ironic was that I had five questions regarding peanut allergic reactions. I happen to be allergic to peanuts myself, so those hit home. Then, when I got three pharmacology questions, I had to chuckle a bit. Yes....throw the pharmacy technician more questions about drugs... I imagine the woman watching the video surveillance screen saw a combination of the Emperor from Star Wars and Mr Burns from The Simpsons on my face.

Hello fellow EMTCity-dwellers. Good evening. I felt compelled as I left work today to post up my little success. I took my NREMT Basic test this morning at 0800, and at 1430 was rewarded with the results. I passed on my first attempt.

I want to thank the people of the board. Even though many of the topics in the Scenario board were way above my head (and cert level), reading through them has helped me understand the process. The articles posted in different threads, on Facebook, and found through browsing have also helped me learn. I really want to thank the members who post in the "I didn't pass" or "help me pass" types of threads, because many of the tips offered (time and time again) really worked.

So now you all are stuck with me. EMT-Basic (Soon to be Paramedic student) Eric.

He's done a few other pieces before, specifically about Detroit EMS. The first, called "No Unit Available... PERIOD" is about the lack of EMS coverage in Detroit.

The followup video to that one, approx. one year later.

Oh, and just to show you how messed up the system is, it's mentioned in one of those videos that Wisam Zeineh and his partner were suspended without pay after commenting to the media the first time. He was such a whistle-blower and such a stink was raised that he was eventually reinstated with back pay.

http://www.myfoxdetroit.com/dpp/news/local/detroit-ems-rig-stranded-as-gunfire-rings-in-the-new-year-20120103-ms

As gunfire erupts all around, Detroit EMS workers are stuck on the road with a broken down rig.

The state of the Fire and EMS departments of Detroit, one big joke. It seems like every other day, the city is feeding it's citizens some new lie about how they've ordered replacement rigs, or how they're refitting old rigs, or that we don't have enough medics to run calls. The EMTs and medics speak out, trying to use the media to garner some needed attention, but the city isn't listening. The citizens blame the EMTs and medics when their loved one dies, saying that they aren't working hard enough, or that they should have been there sooner.

Sorry for venting, it's just so frustrating to see the state of things in my hometown, and knowing there's nothing I can do about it.

1. Sons of Anarchy

2. Sons of Guns

3. Mythbusters

4. House, MD (It's not Lupus)

5. Terra Nova

6. Family Guy

7. Saturday Night Live

8. Robot Chicken

9. Gold Rush

10. Mike and Molly (I know... I watch it with my wife, and it's actually pretty funny)

My question is this; If the IV was medically nessesary for this patient, is it fair or correct to say that transport was delayed? Or would it be more correct to say that transport was rendered when the nessesary medical procedures were completed in accordance to the evaluation and treatment plan set forth by the medics on the scene.

I think the thing that might come back to haunt them (or it very well may NOT come up, because of the "damned if you do, damned if you don't" response of the ER docs) is your question, or rather an answer to it. It's all about how any other medic would have handled that case. Given the circumstances, if 9 out of 10 medics would have done the IV on scene, there was no deviation from standard of care. Heck, make it 5 out of 10. However, if competent professionals can attest that they would have given the IV en route to the hospital, and that extra 3-4 minutes (am I being too generous with that estimate?) could have saved her life, then that could be deemed as negligence.

Now again, this is Canada, where the legal system makes slightly more sense than here state-side (except for the funny wigs... why Canada? Why the wigs?). In Canada, I would like to think that they would look at the whole picture and say "regardless of when the placed the IV, regardless of standards of care, this patient would have died".

"Would you just look at it?" - Comes from a guy in EMT class who was a big fan of the Ed Bassmaster channel on Youtube. It's from one of his characters. It was funny, but now I say it, my wife says it, and just about everyone who was in our class will respond with "well that's all you can do is just look at it".

I would have thought that was the look she gave first time ol' Wild Bill dropped his drawers (well, in her presence at least).

ASK QUESTIONS! There is no such thing as a dumb question

Well actually I've taught a couple of emt's and medics who indeed did ask a dumb question. There are some people out there who you cannot cure of Stupid.

Good point. There are always the ones who you wish would just become LPNs and stay away from EMS altogether.