paramedicmike

Welcome.

Welcome.

Welcome.

Welcome. Virginia is a nice plce.

Welcome.

Welcome. Please keep up the continued work towards completing a degree in an EMS related course of study. Don't give up on obtaining an education in, and completing degree requirements for, registered nursing. Not all nurses work in hospitals. Having a nursing background in combination with an EMS background can open many doors for you that simply having one or the other can't. If you decide to come to your senses and leave Florida behind you there are places where a combination EMS and nursing education can complement each other quite well. You will need some hospital based nursing patient care experience. However, you aren't and won't always be limited to working in a hospital. As an aside, people don't choose EMS for the money. Is it challenging? At times, yes. Does it pay well? Not so much. To answer your questions: 1. Too much to type out here. 2. Yes. I would've started sooner. 3. What do you want to do? In Florida you're somewhat limited to working for the fire truck drivers. Outside of Florida you're looking at opportunities with fire departments, municipal third service, military and other EMS agencies. Get a few years of experience under your belt and you could move into critical care transport. Get a few more years of experience behind you and you could be looking at remote medical support services (e.g. oil rigs, overseas industrial sites and more). With a combination NRP/RN you'll be even more versatile.

I like this part from the Edmonton article: Perhaps a conversation with the reporter and some education regarding the limited time frame for tPA administration is in order. It'll be interesting to see some of the follow up studies from these four ambulances.

This.

There are some notable limitations to this study (that are discussed within the article). However, it is interesting to note that prehospital cooling didn't lead to a faster time to temperature nor did it seem to affect outcome. More study, as always is the case, is warranted. Click here for the study.

Based on what's there I kinda' thought the same thing but it's all too irregular. Agreed.

This one in Colorado. The pilot was killed. Two others injured. Condolences to friends, family and colleagues of the pilot and injured crew members.

I heard some interesting discussion about this study (in combination with several other Japanese and Korean studies) not too long ago. It seems that many times when codes are worked in Japan and places in Korea, where densely populated apartment buildings and small elevators are the norm, patients, prior to transport, are secured to the stretcher in a foot down head up position much like standing. The thought is that this position facilitates drainage from the brain much like in a live person. The question raised is whether or not this positioning affects outcome.

Welcome back. No new management. Just a redesign and update of the site. I think that's happened twice in the past ten years or so. Everybody's was wiped out with one of the upgrades. Nothing big has really happened. Things have gradually slowed over the past couple of years likely due to a variety of reasons. We do still get some lively discussions. It's not completely dead around here.

What else was up with the patient? History? Meds? Symptomatic?

As an EMT maintaining a NR EMT certification depends on where you are. And moving with a NR EMT certification is hit or miss. Some places will accept it. Other states will tell you they don't care. As a paramedic, however, maintaining a NRP certification can be beneficial when it comes to reciprocity paperwork. It will help make the process somewhat easier if and when you decide to move. No. NJEMS is vastly different from the rest of the country. With the First Aid Council hold on state EMS it's amazing that NJ has a functioning EMS system at all.

No direct experience. But it is an accredited program which is something. Will Virtua hire you when you're done? Or do you have plans to leave behind the mess that is NJEMS?

That's money better spent than anything Yankees related!

What is financial stability, anyway? If we waited until we were financially stable to do things nothing would ever get done because very few people out there think they're financially stable.

You've mentioned several different professions here. Are you looking for something easy? Or are you working towards something you want? You've now indicated that you've considered several avenues to the future. This is a smart thing to do. However, your arguments for not pursuing other options (PA, RN) aren't really arguments for not doing it. They're excuses for not doing it. The way you've presented it makes it sound like you think it's too hard to pursue it. You make it sound like pursuing and EMS or FD career will be easier and that fits in better with your motivation. EMS is not necessarily the easier option. As IslandEMT mentioned in your other thread there will be hundreds if not thousands of applicants for each FD spot not just in CT but in all of New England. The same will apply outside of New England, too, with pretty much every department from Florida to Maine. While it may look easier on paper to pursue the paramedic/FF route the reality is not as easy as it seems. Competition is stiff. If you're not a vet veterans hiring preference will automatically put you at a disadvantage no matter how many certifications you have to your credit. People spend years and years trying to get hired by FDs. To push this one step further, and to give you something else to think about, do you want to be an EMS provider? Or do you want to be a firefighter. Why? Sure, if you choose to go to PA school, nursing school, medical school or some other postbacc, graduate-level-education-required profession you'll be looking at time and a hefty amount of student loan debt. It might not be easy. But if it is what you want to do, not because it's the easiest path to something you think you want but because it is what you *WANT* to do, then the time required for school and the ensuing student loan debt can be managed. Age should not be a factor in your consideration. You're still young enough that it's not a big deal no matter which path you pursue. Cost can be managed for higher education. Federal student loans, scholarships, grants and more are available to help finance not only your schooling but to help with cost of living, too. Your future spouse's support, of course, will be necessary. That you're thinking all of this through and asking questions is a good thing. Please, though, don't pursue a particular path because you think it'll be easier. EMS is full of people who are trying to find the easy way. EMS needs people who want to be there to be EMS providers. This will sound harsh but we don't need hose-monkey wanna-bes. We need people who want to be health care providers. I'm not accusing you of being anything at this point. So please don't think I'm pointing fingers. But it sounds like you still have a lot of thinking to do and decisions to make. To help put this in context I am speaking from first hand experience here. I went back to school after many years in the field (and in the air). I'm not just blowing hot air.

Welcome to the City. You'll get a wide variety of thoughts and opinions. Please weigh everything you'll read here accordingly. I'll second the idea of pursuing a degree in whatever field you choose. It will help with employment. It will also help set you up for advancement within whatever organization or agency for whom you choose to work. Barring a degree program, please pick a program that is accredited. If you choose to pursue National Registry certification program accreditation is required. At the very least look for a program accredited by these folks. Three of the programs you're currently considering are accredited. A good paramedic program will offer a variety of clinical settings. This should absolutely be considered when researching programs. Cost is also something to consider. EMTs are a dime a dozen. Paramedic jobs, depending on the job market, can be difficult to come by as well. Do your research for the area in which you want to live and work. It would really hurt financially to spend a lot of money on a program only to not get a job after the fact. This is especially true if you go into student loan debt to pay for it. There is some contention regarding fire based EMS services. Without trying to rehash many of the discussions and debates held on the topic please be wary regarding fire based EMS departments. There are many problems regarding these combination departments with regards to personnel, organizational structure, equipment and more. If you're interested in reading more do some research into any of the big departments out there (FDNY where paramedic to FF is a promotion... really?!... Philly, Washington DC, Chicago, San Francisco etc...). Please also look at places like Boston EMS and King County Medic One (Washington) for examples on well run independent EMS services. With your health care background have you considered alternatives to EMS? How about PA school? How about med school? You have options. Having options is a good thing. Good questions. It's good to see you're putting as much thought into this as you're presenting here.

It used to be a big thing. Not sure if it is simply a change in the dynamics of social media or what. Certainly over the past few years it has not been as popular as in years past.

Point 4: Documentation serves the second and third purposes listed. Report at transfer of care tells the ER what you did. It will eventually be attached to the chart of the patient in question. Usually, though, that's well after the patient has been assessed, treated and either admitted or dispo-ed. Number 28: Is that like Phase 2 of The Underpants Gnomes profit scheme?

Agreed. Minor disagreements with some of the points. Overall, however, it's pretty well done.

We use Dragon to dictate notes into our EMR. You have to be careful with proof reading the chart before signing it. Some of Dragon's interpretations can be pretty interesting.

Last fall I had the opportunity to sit in on a talk with a group of EMS medical directors on this very topic. While I can't find my notes I remember they were, much to my surprise, pretty excited about the idea. There were questions about tPA in the field and the potential liability.