JakeEMTP

Congress disgusts me right about now. What a group of babies.

This funding of the FAA could have been voted on and passed in minutes yet they are too busy scrambling off to their vacations that they couldn't care less about those they furloughed. I'll bet that if congress didn't get paid that they wouldn't leave on vacation till their pay was set up.

Did anyone hear Harry Reid complain about how he hadn't seen his pomegranite trees in months, but he was told they were in bloom though.

This is one more aspect of the congressmembers that proves that they don't have the interests of the people at heart.

I'm done.

What if there were no FAA inspectors? Those douches in Washington wouldn't be able to fly anywhere. They might have to stay in Washington and do their freaking job!

No I wouldn't/couldn't. While helping out during a tough time is admirable, I don't think my creditors would be as understanding. But hey, if I hold a vote and raise my debt limit, I might be able to stand it for a little while.

I think they actually have the Gov't by the balls. If they just said "fuck it" and didn't show up, the country would come to a stand still and they would have to be paid. It is not prudent to ask people to work for nothing, AND (Gasp!) charge their work related expenses to their own credit cards? I realize this isn't an unheard of practice, but where is the guarantee said expenses are going to be reimbursed and when? I mean, if they can't pay me, how are they going to reimburse me?

It is a tangled web we weave.

Starbucks will give us a free regular coffee, but I always put $1 in the tip jar. The hosemonkeys are starting to abuse it though. Regular coffee is free, premium drinks you have to pay for. The knuckledraggers now will ask for a "shot" of this and a "shot" of that so it is almost a premium coffee. I can soon see this perk going away as I have been informed by a employee that the mgr. is getting a little miffed. Somebody always has to spoil it for others.

There is a restaurant that only charges us $5.00 for the lunch buffet, which is about half price. Appreciated, but never asked for. This to is short lived because some members of the local fire suppression are starting to make it a family affair.

Just saw this on the NPR website. Turning juvenile delinquents into EMT's and then placing them with ambulance services. In a State where there are 25 EMT's (or better) for every position, who thought this was a good idea? I would hazard a guess that none will be placed with SFFD. The IAFF wouldn't allow this. Craziness. I would propose turning them into hosemonkeys and let them fight the wild fires instead of playing with people's lives.

http://www.npr.org/2011/07/27/138761686/calif-county-tries-turning-juvenile-offenders-into-emts?sc=tw

I'm kinda going with Kiwi here. Pacing would work nicely with this pt. if Atropine didn't. I'd may have tried 0.5mg of Atropine first prior to pacing. Either way, a HR of 36 is not good and it would be considered bad form to show up @ the hospital with just a fluid bolus that didn't fix the problem.

W/o a strip though I can't tell you exactly what I think it might be.

Kudos for asking for opinions though!

I've been to the Cath lab several times since becoming a Paramedic. We always ask if we can stay and have never been refused. The last one they did was through the right wrist. That was a first for me.

Part of my clinical rotations for Paramedic classes was some time in the Cath lab and found it to be an interesting experience.

That's the one. I still can't believe they let that happen. And they're lucky to have landed in the field like that. It could've been so much worse.

Where they landed the second time, was a much superior LZ than the first. Question for you Mike, I personally have never witnessed a helo shut down @ an LZ. I don't know if that is common to BC or is common practice. Is that the way your crew is on scene? Help me out would ya?

Yeah, we have clean water to wash, clean clothes and drink as much as one can. I have washed cut of my own and my children with tap water w/o any ill effects.

While not totally relevant to the current conversation, my favorite comedian Lewis Black has a few ideas about water.

I wonder if it would provide a bit of a jaw thrust when in place? That would replace an OPA would it not?

I hope to find out and will let you know when their free sample gets here and I've had a chance to play with it.

http://hawaii.gov/dcca/pvl/faqs/medical_faq/pvl_faq_emtb_emtp.pdf

http://www1.honolulu.gov/esd/ems/

http://amrhawaii.net/

I usually try to do it while compressions are still going. If I'm having trouble I'll have my partners pause for just a second.

The bougie has been really helpful in maximizing my success. I pre-load the tube with a bougie instead of a stylet and let it protrude a few inches beyond the end. $$$

I like intubating codes because it is a definitive airway that does a reasonably good job at protecting the lungs from blood and vomit. That, and I like to take every opportunity I can to practice the skill. I won't sacrifice time or compressions to struggle with the tube, but when I can I like to intubate.

Yeah Fiz, I should've added if the pt. is fortunate to regain ROSC, I have no problem inserting an ETT. I too like the bougie for tubes.

Agree with CHbare and Kiwi here. If I can ventilate the pt. well with a King, I won't pull it. Even the AHA says an airway is nice but chest compressions are paramount. As long as you have an airway, carry on with compressions please.

The LMA was designed for and works beautifully in the OR. It has absolutely no place in an ambulance. Unless of course you have a dedicated LMA "puter back inner". Used one once and promptly through the other one in the trash.

We work 24 hour shifts. Accordingly, we are paid for the entire duration of the shift regardless if we are running calls or in bed. 24 hours worked = 24 hours paid.

While most people would probably agree that my big shears are probably a weapon, we are not allowed to carry weapons. We are not required to, but allowed to wear a Kevlar vest at our own expense. I personally hope to never have to carry a gun, but I do see the possibility of pepper spray or tasers.

Maybe midazolam blow darts?

I agree. I like the Midazolam idea. I have many times thought a Haldol-pen similar to the epi-pen is long overdue.

Pre-test for EMT-B... NO! It is an entry level position.

Pre-test for EMT-P... YES! If you do not have EMT-B knowledge mastered then you should not be a Paramedic!

I disagree, somewhat. Yes EMT-B is an entry level position, but I still think a pre-test along the lines of the HOBET test should be administered prior to enrolling in class. It doesn't need to be as extensive, but you get the jest.

As for the second comment, you will find many here that disagree with being a basic first and advocate acquiring at minimum an AAS degree. With 2 years of full time classes with clinical time, one should be able to master the skills of a Basic fairly easily. Anyway, it's all pt. care as in total pt. care, not BLS/ALS right?

I really have no idea about the DFW area. I think, Dallas is fire-based, but don't quote me.

I just want to congratulate you on getting your degree and not taking the easiest route to the world of EMS.

If I'm not mistaken, I think TX will have you licensed instead of certified for obtaining the degree! That in and of itself is something!

Good job.

Jim

Classic Kelly! I'm still laughing!

But I hear that in North Carolina, you have to get approved to work in each and every county.

Most EMS systems in NC have their on Medical Director. Therefore, you have to get your local credential in each County. After all, if one is going to work under his/her license, shouldn't he/she have some say in who the provider is and if they are competent as a provider?

I passed both the written and practical NREMT exams last week! So I'm now officially certified. Should start working with a Volly department in a few weeks (while looking for full time gainful employment).

A major thanks to those on the site who offered and provided assistance and support!

-MetalMedic

Way to go Metal! Congratulations! Now go directly to medic classes!

This one is not from my class, but from another college not to far away. Not to bad.

You did fine on the scenario. The fractured nose, which is extremely vascular and does have the ability to produce copious amounts of blood, was a distraction or curve ball if you will.

As stated above by our esteemed colleagues, hemorrhage control doesn't mean squat when the pt. is a code.

Good luck!

Once again I agree with Mike on this one. Based on your second post TC, I would not suspect CHF, rather the other option, "Dude was fat" Sometimes you just can't be politically correct! If you must, morbidly obese seems to work.

Is there a "please" anywhere in there?

Or even a "thanks in advance".

I work in NC but not for one of those agencies, although I do know a few that do. MEDIC seems to have a revolving door as they are SSM. The folks I know who work there though seem to enjoy it and have been there for some time. BUSY, BUSY, BUSY service. It is not unusual to have several calls pending when you check on at the beginning of your shift. WCEMS seems to be in a bit of a hiring freeze from what I understand. That being said, there is no harm in applying. Their fiscal year ends in June and that may create some opportunities. If your looking at NC, I suggest you look at www.NCEMS.org for employment openings. Forsyth County, Durham County, Orange County et al, are all good services.

We were dispatched to the waiting room for CP once. We were in the EMS workroom so it wasn't to far

to go. Anyway, the folks around here know how to get a emergency response. It;s either CP or respiratory distress. However, we treat everyone the same. Turn out to be a STEMI and we wheeled the pt. right through triage and into the ED, stopped long enough for the Attending to confirm our findings and continued straight to the Cath lab. The pt. did have a positive outcome.

So yeah, not all pt.'s who call from the ED waiting room are self centered and full of shit. Do your job and treat the pt. appropriately. That is what we are here for.

One other time we explained to the pt. what the word "triage" meant. After doing our assessment we advised her that she would not be seen any sooner if we took her through the back door and would "loose her spot in line" if she left. However, we did not refuse to take her stating it was her choice to come with us or not, but also informed her that she was most likely going to be "triaged" back to the waiting room.

Update: I didn't get the job. They said they'd put me on the "immediate" list for the next time a position opens. So, yeah.

That sucks man. Keep your chin up! They put you on the "immediate" list which I assume is the immediate hire list. That's something. Who knows what their criteria or reasons for hire/not hire was. The good thing is, your young and your opportunity will come. When it does I know you will be the best medic you can. It is their loss in my opinion.