Rezq304

Wow....looks like I'm lumped in with the rest of the crowd. I'm Spongebob.

The EMT-I85 is basically the equivalent to Virginia's "Enhanced". It's basic ALS skills minus the cardiac portion. Also, it just scratches the surface on Pathophysiology and A/P.

I was thinking the same thing myself Anthony!

Here's how I handle it man..... The evaluator reads the scenario. "BSI, is my scene safe?" Then I ask myself if it's a trauma or a medical. If a trauma, I'm going to ask about the mechanism of injury. Then, is this my only patient? If so, I would state that most likely the crew on scene can handle and wouldn't need additional resources. Then, consider cervical spine precautions, then state my general impression of the patient. Then, starts the hands on. My partner takes C-spine. Open the airway with a modified jaw thrust. Look, listen and feel for breathing. If no gag reflex, I'm going to drop an oral at this time. Assess breath sounds. Depending on respirations, I'm going to either place my patient on a non-rebreather or have my other partner deliver respirations via BVM. Then, I'm going to assess circulation. What's the pulse rate? Is it equal between the carotid & the radial. What's the skin color, temperature and condition? Any major bleeds? If so, control them. Then, after initial ABC's, I'm making a transport decision. If I decide to make it a load & go, I'm going to DCAPBTLS C-Spine & assess for midline trachea and/or JVD. I'm then, going to assess CNS function. THen, I'm measuring and placing a C-Collar. Rolling the patient, assessing the posterior surface for any DCAPBTLS. Rolling back onto the board making sure to FILL THE VOIDS with sheets. Strapping and securing and moving to the truck assessing CNS function after the move. Once in the truck, I'm doing my detailed exam. DCAPBTLS everything. Pupils PEARL? Vitals? Bebinsky? I'm going to start at least one IV line and bolus fluids if no suspected hemorrhaging in the brain or an aortic tear. Bolus at 20cc/kg. Continue to reassess the patient throughout. I'm going to make sure to keep my patient warm and if they start to exhibit signs of shock, then trendelinberg. Call in report to the hospital and let keep assessing all the way in.

Hey guys....I'm in the fray with you all. Just finished up my first year of a two year program. We take our capstone on Sunday which will tell us if we'll be signed off to test NR EMT-I/99. When ( I say that with a grain of salt) I pass this Sunday, I'll probably test Registry I in June. Then, we go back for another year and then test Medic. Remember guys, just keep chuggin' along. It'll all be worth it in the end.

Fools paradise? Please elaborate.

I can see that now!

EMT- Enhanced is basically an advanced basic level. You get intubation, IV, & non-cardiac meds. Here in Virginia, all meds have to be cleared by med control before given. I'm at the Enhanced level right now. I'm using it as a step to Intermediate. I'm currently in a paramedic program and we were offered to test Enhanced at the end of our first of five semesters. I'm getting ready to test NREMT-I/99 next month. Basically, it'sa good way for me to practice and hone my IV/Intubation skills since we don't get to keep practicing them every night in class. I like the idea, but I'm with most of you guys. EVERY state needs to go to only having Basics & Paramedics. As far as the Enhanced test, I found it rather easy. Remember ABC's. honestly, I could've passed the Enhanced testing before ever starting an ALS program.

OT.....great set up you have in Charlottesville. I'm from SWVA. Just took a Vehicle Rescue class from one of your guys up there. GREAT teacher...he really knows his stuff!

I never said that you should pass judgement. I'm just saying that it's kind of disheartening knowing that the person that you're attempting to save, just took two other lives.

Good point. The one thing in your scenario that my area lacks is inter-departmental communication. It's almost as if the Fire Depts and EMS butt ehads everytime they work together.

Who handles it in your juristiction? Here, EMS does extrication, however it wouldn't bother me to give it up and let the Fire Dept do the cutting. This is all assuming that ALL FD members become AT LEAST First Responder certified.

We have it set up here similar to what you've stated. OUr paid service actually has AT LEAST one truck on duty 24 hours from 6am Monday to 4pm Saturday. Our volunteer service handles the calls from 4pm Saturday to 6am Monday morning. Dual tones are set from 5pm to 11pm on weekdays so that both can possibly respond. Also, if the paid service gets backed up, the volunteer service picks up the slack during the week. Personally I don't like it. I wouldn't mind seeing the volunteer & paid services merged. Still have folks that don't want a career in EMS volunteering, but you also have the "paid" medics on duty 24/7. I've seen other organizations that run like this and I have found that they run MUCH better than the set up we have now.

I rode the busiest ambulance last year. The dept ran somewhere around 1100 calls for the year. I think I averaged out at about 15 calls a month. Mind you that this is a fully volunteer department too.

As a follow-up, multiple eye witnesses stated the RV veared into on-coming traffic. Also, multiple eye witnesses placed the vehicle just prior to the event swerving almost causing two wrecks prior to the one listed here.

Unfortunately Thewho, but it's an addiction I'd rather not break!

I'm currently using the Mosby book. I absolutely DO NOT like it. Seems to lack organization. NExt semester, we are switching to the Brady book and from what I've been told, it is MUCH better!

Thanks to everyone for the input!

In doing some further research, I've heard that PEPP is more for Peds to keep them from "circling the drain", while PALS is more geared toward Peds when they're already "circling the drain". Can anyone confirm this?

Here, we're given probably 2-3 new screen printed T-shirts or long sleeve T-Shirts a year. Everything else is up to us. Personally, I have a jump suit. much easier to put on than to "gear" up in the pants and shirt.

I work at a University on the east coast that currently has a very well organized Rescue Squad. If you'd like, I can get you in touch with some of them and you can talk to them firsthand. Just email me at rezq_304@yahoo.com and I'll see what I can do for you.

Nope and doubt I ever will! The person below me skinny dips.

Answer-Lay down on the ground and proceed into a nervous breakdown. REAL Answer-Stay calm, call for THE CALVARY. And when I say the calvary I MEAN the calvary. EVERY available fire unit. EVERY available EMS unit within a 4 county radius. EVERY medevac chopper that will respond. Me, I'd probably try and pull people from the burning fire truck. TRIAGE TRIAGE TRIAGE!!!!!

Amen to that...that is what happened to me and it was the best thing that could've happened for me!