JakeEMTP

Hey, Congratulations! I have a friend currently enroute to the Buckeye State (Lord only knows why), he doesn't have to pass through your district does he?

It appears to be a newspaper out of Las Vegas, "The Review Journal". They and another company Righthaven LLC have partner to bring the lawsuits. I would post the link, but I don't want to bring further litigation.

To be completely honest, I would have never thought to administer Glucagon IV in an arrest. Thanks for the info Dartmouth Dave and Crapmagnet for beginning the conversation!

The State of NC requires a background check before you can test. When I applied to begin my paramedic education, a background check was a requirement before being accepted into the programme. I can't remember if I needed one before basic class. I do know I needed one before State testing, which was somewhat difficult because I didn't even have a SSN then.

It makes me want to vomit. I like you Tskstorm, am so sick and tired of this behavior. I know most on this board work hard to promote EMS as a serious profession. Chuckleheads like this just give us all a bad name. Regardless of if the accusations are true or not does not matter. The fact that they were made at all is a detriment to my profession. There would have to be at least some truth to it for the young woman to say such a thing.

Uglyemt and BoCat, Don't take everything so personally. Far be it for me to speak for Bushy, but from what I took from his post was he was advocating ALS (or total pt. care, which I personally prefer) everywhere for all patients. I don't think he was slamming you personally. I don't think your comment about all ALS providers would be detrimental to employment is valid. What we do is about treating the pt. accordingly. If that means that non ALS providers need to step up and increase their education then so be it. No matter what the level of provider the crew members are, there will ALWAYS be a need for 2 of them. I also have to disagree with your hospital based ALS theory. Outside of NJ, this is the exception and not the rule. As an example, here in NC very few EMS agencies are Fire based and even less are hospital based. I can't off hand think of even one. Hospitals provide critical care inter-facility ground/air transport. The flight services are also hospital based. Most EMS is provided by the Counties. There are only a few of the 100 NC counties that do not provide paramedic level care, and that is going to change in the future so all residents will have access to ALS care I have heard. So you see it can be done. It just is a different way of thinking as to providing for the citizens the best care possible. You no doubt are an excellent provider. It isn't fair though to your pt.'s that they are denied advanced care because your scope is limited.

Where in the Tarheel are you located? There are a few of us in the City from NC. I'm in Pitt County and we have others from Wayne, Wake and a few others. True, no two calls are identical. They may have similarities, but identical, very rarely. EMS was once described to me as "extended periods of boredom, interrupted by moments of sure terror." While not entirely true, the quote has some merit, depending on the service you work in. Welcome to EMT City! You will find a wealth of information here and don't be afraid to ask questions. We were all in your shoes at one time. There are a great number of highly educated, well seasoned providers who are willing to share their experiences and knowledge with you! Herbie brings up a great point. If EMS is truly what you want to do, then embrace it. If you want to use EMS as a stepping stone to further your medical career, than pursue that career. What ever you decide, you have come to a great place for reference.

P3medic, I feel I have to disagree with you here. Obviously you have never broken anything before. If a service has the ability to control pain, then it needs to be done. Who are we to say whether a pt. needs pain control or not? If they hurt, they get relief. Not if every ambulance had the ability to perform ALS interventions. Other major cities in the rest of the modern world do provide all ALS services. Why can't it be done here? Nonsense. See above. Other major urban centres World wide can do it. It is the responsibility of the provider and the service he works with to maintain their skills. Here we have to perform BLS/ALS skills annually in a clinical setting to be able to continue as a provider. Sure it's a pain in the a$$, but a necessary one at that. Intubation is falling to the wayside BTW. Basic airway interventions will do in most cases. I have only had to intubate 3 times this year but still manage to do it in under 10 seconds. Again, it is up to the individual to keep up to date and proficient.

Yeah, MEDIC is the only system wide service I am aware of that has Nitous. There is one service in our County that carries Nitrous Oxide, Eastern Pines EMS. I have never used it in pt. care personally. We have Toradol, Fentanyl and Morphine for pain control. Regarding the topic, ALS intercept never really made sense to me. Why not just have all ALS providers, then the pt. doesn't have to wait for treatment other than having their face blown off by 15lpm high flow O2?

Aeromedic, We use the EMSmanager programme for our time sheets. It is the responsibility of the employee to enter their time correctly, then checked by the supervisor and forwarded to payroll. Due to your different pay rates, it might not work for you, however I think the programme is flexible in it's use. I know it's not free, but I don't think the cost is exorbitant either. I do think they have a free trial period for you to try it first. Sorry I couldn't be more helpful.

Yeah, I think I'd try a combivent (Albuterol/Ipratropium), 125mg of Solumedrol IV and perhaps an Epi Drip (here I have to call Med. Control for this intervention, but I have done it on a Anaphylaxis call). Since you maxed out on your Fentanyl, do you have the option of Toradol for pain control?

Kiwimedic has provided facts, many times in fact. Do you have any facts and figures to dispute his post?

Do you seriously believe that? How is it possible for an EMT-B to have the ability to decide whether or not ALS is required when the current entire EMT-B class was shorter then 1 of my A & P classes? Following an algorithm hardly constitutes an thorough assessment. The key is what you don't see. And seriously bro', NJ is hardly a shining example of how EMS should be done. If ALS is going to be dispatched anyway, why not just send them? It's only fair to the pt.

What we need to do is forget this BLS/ALS Bullshit. It is all pt. care. If I was the pt., I would hate it that an ambulance shows up and can offer me O2 and a ride. I would deserve a educated assessment by a educated provider and if I needed further interventions, then I could get them then. Not wait for the ALS truck to show up. Aeromedic, I'm surprised you don't have more confidence in your pt. care abilities. From your post it sounds like your more concerned with making mistakes than treating the pt. I can get a 12-lead in less than a minute. I don't need someone to do it, although it is nice. We ride double medic here. Everyone gets a thorough assessment and immediate transport and interventions if required. Does every pt. require advanced interventions? Of course not. However, when they are, pt. care is not delayed because we're waiting for advanced providers to get there. Another thing, Basics are for the most part, unable to determine if an intercept is necessary due to their lack of education. Another reason to have all further educated providers. In most Countries, EMT-B's wouldn't be aloud on a ambulance due to their limited education in EMS. Why do we allow it here? Anyway, these are my thoughts. After being a member here for a considerable amount of time, and having taken part in many of the same debates as this, I think I'm done with this thread.

Thanks Ruff! I just downloaded the Blackberry version. Something to play with when I get to the "office" tomorrow!

NC requires you to already hold a EMS certification before you can be considered for reciprocity. Anyway, here is the link. http://www.ncdhhs.gov/dhsr/EMS/resopros.htm NC is also a non NR State.

It's not that I need an ambulance to work in, it's what the ambulance has on it that I need. Seriously, I don't have anything in my personal truck that would be any good on a call. I have no identifying wacker stickers on it. Fortunately, in NC we are not obligated to stop and I don't. As you progress in your career, the "I got into EMS to help people and save lives" mentality will fade along with the adrenaline rush. It's true, that's why we're here, but it is a job, and it's not 24/365. What are you going to do anyway as a EMT-B which would fall under your scope and be a life saving intervention? Do you honestly carry O2 in your car?

Way to go Lisa! A & P is possibly the most important course in your paramedic education! Keep up the good work. Take a break as our esteemed colleague Dwayne suggests and enjoy it. Then get right back to the books young lady!

Our protocol is as the others have posted. NTG and CPAP. Lasix is still available, but requires medical direction. I have posted the protocol for your perusal. http://www.ncems.org/pdf/Pro28-PulmonaryEdema.pdf

I'm not a huge fan of rap/hiphop either. I will however give credit where credit is due. This was a pretty well written and performed video which I enjoyed. Anytime EMS can be promoted in a positive light, I'm all for it. It was well done, as was his previous video "Call 911". Kudos to Farooq for doing this. Keep up the good work bro'!

I kind of like the idea Docharris's service has. I've never been one to care much about trinkets. I have enough t-shirts and coffee mugs to open my own outlet. We should use EMS week to promote the proper use of EMS, educate the public as to when is the appropriate time to call for help, BP checks and the like. Get out in to your district if time permits and introduce yourselves. I taught a Safeteen class today to the driver's ed class at the local high school. For those that do not know, Safeteen classes are meant to inform new driver's a what can happen in a wreck, the effects of ETOH and driving etc. It is taught in conjunction with the Highway Patrol and the Trauma Centre. Sure it's always nice to get a pat on the back. However, I'd be happier if I could get one person not to call in the middle of the night for something that does not require immediate attention than a t-shirt.. We push education here at the City. Let's do our part to educate the public.

Have they actually done any research, or are you just assuming EMS transports make money? What a bunch a wankers. Bumper stickers? Seriously?