txladymedic

LOL I am on of the odd ones that will go to other states especially if something is offered elsewhere that isn't offered in my state.

Alright, so I admit as of late I have been entirely too busy to lurk. But I came by looking for classes and to generally lurk. As a provider as well as an instructor that puts on regular card and CE classes I got to wondering, Is there someplace on the boards that has a list of upcoming classes that we could both reference and post classes? Thanks, Sarah

If it is a private club taking no government money I fail to see the issue. There are still some women only places so why should it be "good" for us to have a women's only place but throw a fit when there is a men's only place?

That just sucks! It sucks when you lose not only your patient but the life of someone who hasn't even had a chance to live and is in essence an innocent bystander to the situation. It's always nice to have one of those calls after something like that you can go "Good save!". Sometimes it makes the suck go down just a little easier. There will always be a call or two that affects you but hopefully as time goes on the sting of it dulls. Hang in there!

http://www.gerber-tools.com/Gerber-Hinderer-Rescue-22-01534.htm I have one of these, the tip on mine is kind of blunted for use as a screwdriver. Had it for several years and it has held up well.

I have a kindle myself and use it some for college. I find that for books without a lot of pictures it works just fine. For example my Sociology, Psychology, English books the kindle is great. I do not find it works well with books that have alot of pictures that you might need to see the detail such as biology or A&P. However, both my A&P and biology texts can with an online version of the book that is identical to the book and since I have to have a lap top to do most of my work anyway that works out well. Down side is you have to be online to get to it but I found that if I am going to do some traveling and won't have internet that I can print to PDF form and access it that way when I am flying and such. I do like that the kindle is not back lit and find it is easier on my eyes especially since I can increase the font and sometimes even let the kindle read the book to me. Most times however I just increase the font and read it myself, unless I'm trying to multi-task. I can't speak to the Kindle Fire but I might see if I can find some place locally that has a demo model that I can go put my hands on as it seems like it might be an improvement from the last kindle. OH and I like that the kindle has internet built into it and it doesn't cost me to use it. While not as user friendly as say an ipad, I have to say it still is pretty useful especially in a pinch.

By the way, I wanted to say that I am really enjoying this. I don't get to use my remote duty set of skills much anymore. And we usually didn't have the luxury of things like labs or x-rays unless we sent them out when I was actively using those skills.

Depending on how long this has been going on I might be comfortable just sending him home with ORS/fluids, recommendations to tank up on fluids and continue with tylenol prn for fever, recheck in the AM or sooner if the symptoms change or worsen. If I am going to do an antibiotic, I personally like Augmentin to start and if there is no improvement then work my way up the antibiotic food chain. But I am not opposed to considering others. Oh yea...does he have a rash?

With the lung sounds and fever....I'd like to see a resp rate, an SPO2, & B/P. Dizzyness? Lt. headed? What OTC meds has he taken? Anything make it better or worse? How long has this been going on? How much water has he been drinking? Is he drinking more or less than usual, is he urinating more or less that usual? Nausea/vomiting/diarrhea/constipation? Sore throat, runny nose, ear pain and if so what do his ears look like? Do you have anyone else that has presented to the clinic with similar symptoms? Allergies to meds...or anything else? Does he smoke or drink? Has he recently quit smoking? History of seasonal allergies? Without knowing anything else and just taking his lung sounds and fever into consideration....have him increase his water intake, might even consider ORS, tylenol 500mg q4-6 hrs possibly consider alternating with motrin 400 mg q4-6hrs, consider an antibiotic...augmentin 750mg BID x 10 days, zpack per pack directions or doxycycline 100 mg BID x 10 days. Recheck in the AM or earlier if symptoms worsen.

LOL well I wouldn't know...I've only flown with male nurses. I tend to fall into the category of "Well behaved women rarely make history" thing. It was nice to have somebody when I was flying with a little more experience with ICU patients or with a specialty NICU nurse when you've got a neo with all kinds of issues. And I know that some states don't allow paramedics to do RSI meds but the RN's can and vice-versa in other states so in those situations it's nice to have that ability especially when you are flying. I still don't see paramedics being phased out and it all becoming RN's working ambulances however.

Make no mistake, I do see where RN's have their place in pre-hospital (flight, critical care, Critical care neonatal/pediatric type stuff) and have worked with RN's in the pre-hospital environment. However, If it is being suggested that paramedics will just be phased out and RN's will completely take over the pre-hospital world, I just don't see it happening. Just to start with I doubt most will be willing to take the decrease in pay, and I doubt that most services would be willing to meet or exceed their compensation expectations. I see other possible issues as well but I will not go into those. But as always that is just my take on it.....

Dwayne, I agree! Frankly I don't think the nursing world want anything to do with the prehospital world and I'll be surprised if that ever changes. But as you said, there is always the chance that they will and money will increase. But I think with the recent push for a higher standard of training for medics it will further decrease the chances that we will have the nursing profession invade the prehospital world, and might even promote the other medical professions to have a little respect for us. By the way, I'm glad that I am not the only one that runs into those same kind of bullshit with other remote duty medics....I've seen some stuff that would just curl your toes. LOL If you find a way for us to honor the "do no harm" thing by choking some people to death in an effort to safeguard future patients and potentially even future medics who might learn their bad ways let me know. I'm on board. We should swap stories sometime....I've got some impressive ones, as I'm sure you do. Sarah

I worked as an EMT-B for a while, before and during paramedic school. Toni is correct you will probably have to drive into a rural area that hires EMT-B unless you are willing to work for a transfer service, in which you might be able to find a job working in the city somewhere. Don't be too hard on transfer services, if nothing else it gives you a chance to become very comfortable with the basic skills and gives you great insight into chronic disease processes, both items I found very useful in when I went through paramedic school. But remember the pay isn't great....it's been a while since I've worked as an EMT-B but I was making about $8/hr and ended up working as an EMT-B, a cashier at a convenience store, a fee collector at a park and as an admin assistant for a fire department to make ends meet.

Having worked in a rural system, I see no problem taking 2 or even more if necessary in the ambulance. Most critical going on the stretcher. I have worked for at least one system where you have the capabilities of taking 4-5 per truck....2 hanging, 1 on the bench, 1 on the stretcher and if you have an ambulatory or at least one that can go seated (i.e. a pedi in a car seat) put them in the captains chair or the side seat on the other side. Just depends on what your resources are. Hopefully in the situation of more than one patient you have the luxury of grabbing a first responder with a clue but that doesn't always happen so you end up with either no help or a little help, sometimes a little help is better than nothing. You do with what you have and you do the most good for the most amount of people.

I believe you are right Ruff, so long as you are off duty and especially if you are not in your jurisdiction then you do not have a duty to act. I too do a mental triage, and usually carry no more than PPE and maybe a very, very basic 1st aid kit...and unless it appears serious I do not stop or step in and help. And if I do offer help, I rarely volunteer that I am a paramedic, frankly I don't want the liability. I prefer to provide basic care give a quick report to the responding crew, ask if they need my help and if they don't, then I disappear. But that is just me....

I have to agree with Toni on both the "till death do you part" and the "whatever the wife wants" thing, remember both they will serve you well. And congrats!!

There are so many things to look at with this. Transport time, effectiveness of the patient's ventilatory effort, can you talk the patient through taking deeper and more frequent breaths, O2 sat, effectiveness of BLS airways...and on and on and on. Having worked in a system with no RSI...I personally would have gone with either a nasal airway and a BVM, might have considered a CPAP, and lastly nasal intubation. Nasal intubations are useful but can be difficult if you've never done one. You're right though, if you're going to intubate someone you should as least have the decency to give them some sedation. Even with RSI I might have BLS'd the airway for a while to see if it was going to improve on it's own. I personally hate intubating elderly because of the risk of not being able to get them off a vent. I tend to try every other route before that one. If I am flying however, I tend to be more aggressive and secure an airway faster because I don't want to be in a situation of trying to secure an airway in a cramped aircraft.

Might contact one of the PHTLS instructors and see if they would be willing to just do the skills portion since you can do the classroom portion on-line now.

Experience as a flight paramedic and working in austere environments such as Afghanistan and Iraq....US passport in hand. I'd be interested.

I must have missed that part of the thread too Dwayne....6 (holds up fingers and counts 1,2,3,4,5,6) Holy cow bat man! Unless it is an MVC or a multi patient situation I can't even come up with uses for 6 people on my truck, at the point when there are 6 people in my truck on one patient there are too many people there and in my way. Frankly I'm not sure that 6 people on one patient in the EMS setting is conducive to good patient care, but of course that is just my opinion. And I agree the long and short of this whole discussion is take a little pride in your profession, respect others and yourself. If you can't do that, do our profession a favor and find another career.

I too wonder what has happened to the basics of common courtesy, taking pride in your job, professionalism, and a few other things. Maybe things aren't the same as when I got started in EMS but I started in a time when you took pride in your job, you tried to be professional at all times and applied the basics of common courtesy to everyone especially to others within the healthcare world, you might not always agree with them but you found that time and place and way to politely question why they were doing what they were doing and you remembered that you were going to most likely have to work with these people again and it was important to leave them with a good taste in their mouth so to speak. I am not perfect but I do go out of my way to show up to work prepared and dressed appropriately and I try to insure that my filter is intact and well seated at all times be it when dealing with other public safety providers, or when dealing with other healthcare providers or even when dealing with a patients family or the patient themselves. I attend continuing education expecting to get something out of it and expect that the people teaching it will show some level of professionalism and won't read me the slides as I'm not illiterate, and I expect the other students to at least pretend they are there to learn. Sadly several times as of late I have been disappointed, both at the other students, and/or the instructors. I know that I am light years away from being as up-to-date as a medic as I would like to be, but I try. I make sure that uniforms are clean and pressed at a minimum and that boots are polished. I don't work out as much as I should but I do try to at least make healthy food choices and watch my weight and general health. I go out of my way to at least try to act and sound professional at all times when in uniform. And I expect the same out of a partner. Maybe I'm an old paramedic who expects too much...

My two cents worth, I'd rather have an well seasoned partner than a young one any day. While you may not have the medical experience, you have life experience and sometimes that is just important. As it was pointed out before by someone else, try to remember in EMS there is alot of grey and colors, try not to think in just black and white. Nothing will be as cut and dried as it seems in Paramedic school.

I got my EMS Instructor certification by taking a TDSHS EMS Instructor course through TEEX. Granted that has been about 10 years ago but I know they still hold such courses and I recently saw Kyle FD advertising that they were teaching a Texas EMS Instructor course. I know that the course I took at TEEX would allow me to become grandfathered in as a Fire Instructor if I were a firefighter as well as a Police Instructor if I were a police officer. Sarah

A few years of working overseas with limited resources has taught me to try to know every off label/alternate use of every medication you have access to. Knowing that Benedryl can help with nausea or that mag sulfate can help with severe asthma might save your butt. Of course those are just a few examples of medication uses that might not be in your protocols. Don't just have one way of doing things. For example know a couple different ways of getting IV access. Don't limit yourself to hands and arms, I've put IV's in chests veins, feet, the head, upper arm, and ankle to name a few. Sometimes starting an IV bevel up works better on the elderly and children. Think simple, cause sometimes simple works just as well or better than the complicated. Yea, the fancy toys are great but remember to treat your patient not the machine. You never know when a machine will break or you will work for a service that doesn't have that fancy widga gidga. Think outside the box!! Another example of simple is while working in overseas we had a patient that kept getting a nose bleed and didn't have access to labs. The PA working with us said to stab his finger with a lancet and then touch his finger to an index card and keep doing it every 10 seconds until it quit leaving blood on the card, then count up the spots of blood on the card and then you had an idea of what his clotting time was and helped us rule out a clotting time issue. ADVOCATE FOR YOUR PATIENTS! That's all I can think of off hand but I'm sure I could come up with a few more if I gave it some more thought. Sarah

As far as my degree goes it will be a Bachelors Degree in Emergency Health Sciences. Although I am now considering tacking on either a degree or a certificate in Disaster Management to that Bachelors degree.