paramedicmike

The Onion is an online "news" site full of sarcasm and assorted "literary wit".

It's all in jest and you need to be able to read between the lines.

While this wasn't one of their better works, I did find it quite funny.

Just gotta take it with a grain of salt.

-be safe.

They shouldn't have to turn everyone's POV into an ambulance. They should have a properly stocked and supplied ambulance there for you to use at a standby event such as this. If they don't, to borrow a phrase from Dust, then they suck.

My understanding of EMTs who work at standbys is that of a provider who is hired by a company that owns everything they might need. The EMT is an employee paid to partake in the event as needed. Supplies are stocked in the provided response vehicle. Personal stashes of equipment and POVs are rightly and justifiably left out of the equation entirely.

How can you volunteer for several organizations but only belong to one? What does this mean?

I'm also confused as to what you mean by "freelance". You either volunteer or work for an existing squad as an EMS professional. Otherwise, you're nothing more than a glorified first aider who has no business being involved in anything where you would have to buy such equipment.

Your posts to this point are not painting a favorable picture of you, any organization with which you might be affiliated, or the racing circuit you frequent. As was noted, this is not a hobby. You don't go out and buy equipment to stock your POV. Please either clarify your position here or come to terms with the fact that you're both a whacker and a troll.

At the very least, for your own personal protection from a lawsuit, please affiliate yourself with a reputable, professional organization that takes the role of providing EMS at such events seriously. If you continue here it sounds like you're setting yourself up to get hosed.

-be safe.

I'm not in EMS as a profession; only volunteer on the weekends for non-profit org's, etc.. I think I can get my NPO to reimburse me, although we don't usually use KEDs for dirt bike racers.

While you may not use a KED on a biker, the original question still stands. Why is the organization for whom you're working/volunteering not provide the equipment you (might) need? Do they provide everything else but not this? Do they provide nothing and you're trying to stock yourself?

There just seems to be a better way to do this than you potentially getting stuck with a bill for equipment you shouldn't have to buy.

-be safe.

I remember this, too. Are you sure it was JEMS? I seem to remember EMS Magazine having something along this line. I don't remember which mag or when. If you strike out with JEMS try EMS Mag and see if it's there.

To answer your question, ALS = my chart. BLS = BLS partner's chart (if I'm working with a BLS partner. Most of the time we're dual medic. So it can also be BLS = my chart, too.).

-be safe.

So...about the Hespan....

Why Hespan over something else (like, say, albumin)? Advantages? Disadvantages? Do you like using it? Or is it something they make you carry?

Have you run into anything over there regarding a hypertonic saline solution? I think there was a thread on here not too long ago discussing that.

I'm doing my own reading on this. I'm just interested to hear first hand usefulness, thoughts and rationale for carrying.

-be safe

No! Seriously! Be safe!

Many states have programs in place like this. While I have not personally been a party to such a reception, I know and work with people who've taken in the kids and followed the protocol for care and turn over to child protective services.

While not ideal, I think it certainly gives the kid a better chance than staying with a mom who either doesn't want to or can't care for the child.

On what charges would the mother be brought? She didn't abandon per se. She didn't endanger. In fact, I think it shows that she just might've been looking out for the best interest of the kid.

And to people who have a problem with this, I wonder what they'd prefer happen...drop the kid in a dumpster wrapped in a plastic trash bag?

-be safe.

I guess they pair you up with a partner that has been with the company for a while, and you run as the tech for a certain amount of time until they allow you to drive. That's probably not only for insurance reasons, but also based on the rationale that a new employee probably won't know the area well right away.

You guess? Or do you know this happens?

So how do they deal with the insurance of under 21 year old drivers?

My experience has been the same as Rid's. If you're under the age of 21 you're typically not considered for hire due to insurance regs and the potential for needing to drive the ambulance. And this is consistent over several states in which I've worked or had dealings with EMS...not just one.

I also agree with Rid in that there's plenty of time to take an EMT class. Go to college. Get some solid educational experience behind you. That will help make this class a breeze for you. Plus, it'll give you the opportunity for some solid life experiences. Especially if you take advantage of a lot of the programs offered in a college setting (including study abroad). If you really want to do right for yourself, go to nursing school first. Then earn a paramedic certification. The education received from both will compliment each other and you'll be better off both job wise and financially in the long run.

EMS will always be here. There will always be a roll of EMS in todays society. And there is no shortage of stupid people waiting to give us something to do. Enjoy life some before getting involved in what can be an emotionally draining career.

-be safe.

JEMS Magazine Vol 31 No 7, July 2006 page 32

"First - and this blew our minds - 54.5% of those who are not now practicing reported that they had never practiced."

This comment was made as part of a study on a completely different topic. However, the results do back up AZCEP's statement.

There are more people out there who have it and don't use it than you think. For some it was a "cool" thing to do. For others it's an occupational thing. For others yet it's simply something good to have just in case. (As an example, I used to work as a white water guide in West Virginia. I knew so many people who had an EMT cert simply because they thought it was good to have in case you had an injury while in the middle of a canyon with no immediate chance of evacuation. That and they were paid an extra couple bucks for the training. These folks never practiced anywhere. They didn't volly or work anywhere, nor did they intend to.)

AZCEP, once again, is very astute in his observations and right on with his assessment.

-be safe

Working in EMS gives us a greater responsibility towards our work than other professions might have. It's not about us. It's about our patients and the people we serve. If these providers strike then their employers should take every step within their power to have every one of their sorry a$$es fired.

There are other ways to get your message out and raise awareness of your dispute. By striking you only alienate yourselves further.

If these boneheads strike then every last one of them should be fired. And if I could deny them unemployment I would!

I have a back up question on this topic and it fits very well here.

For those of you who are working with the system in question, are the full time employees guaranteed 40 hours minimum?

My understanding, from what my friend explained, was they had a 36 hour work week (3 x 12 hr shifts). They did work three shifts a week. Just that they (full timers) were scheduled around the part timers availability.

Still trying to wrap my head around this.

-be safe.

Ruff...that's horrible. Sorry you had to deal with that. I can't even imagine what that must've been like.

-be safe.

Just who is AMR taking over in Montco, PA?

Oh, and if I'm not mistaken, the cocktail is: Versed, Norcuron or Vercuronium, and Potassium Chloride. In that order.

ug

Here are my sources for the meds used:

http://en.wikipedia.org/wiki/Lethal_injection (not authoritative but available none-the-less)

http://www.deathpenaltyinfo.org/article.ph...d=8&did=479

http://www.statesman.com/news/content/news...6/13lethal.html (please note the line that says that Texas uses the same three drug combination that other states have adopted.)

These are three among many.

Please provide your sources saying that the procedure is something different.

Thanks for the clarification mike, I couldn't remember with 100% certainty but I thought it was calcium.

No worries.

As far as you disagreeing with my comments on it not being a big deal, I think you misunderstood me. It's not a big deal to teach someone how to start a line and perform whatever procedure goes along with lethal injection...

Got it.

... as far as the end result goes now that becomes an issue of semantics and I won't discuss that with anyone on this or any other forum.

Fair enough.

Thanks again for the clarification but the initial procedure is the same as doing RSI and most services do have standing orders to administer those meds.

Well, not really. Sure, if you look at the basic steps of sedate and paralyze then yes, it's similar. But these are the most commonly used meds used in lethal injection and are not available on standing orders to most (if any) services:

Sodium thiopental: to induce a state of unconsciousness intended to last while the other two injections take effect. Not commonly used in prehospital RSI due to the lack of analgesia provided by this med.

Pancuronium: to stop all muscle movement except the heart. This causes muscle paralysis, collapse of the diaphragm, and would eventually cause death by asphyxiation. This isn't used either due to it's long onset and long duration. Perhaps it might be used once tube placement is obtained as a long acting paralytic. But it's generally not the first choice nor am I aware of any service, ground or flight, who uses this medication in the field.

Potassium chloride: to stop the heart from beating, and thus cause death. This is not in any way, shape or form in any paramedic level formulary.

I'll agree to a certain extent that it mimics an RSI procedure in preparation only. I will disagree, and continue to argue, that these meds fall within the SOP of paramedics...certainly they're not part of any standing orders to most services out there.

-be safe.

Actually, I think the drug most commonly used to actually kill the inmate is Potassium Chloride. And KCl is certainly outside the SOP of any medic out there. I've never heard of CaCl given to kill the inmate.

And no matter how you spin this it is not included in any SOP out there. It can't be compared to an RSI as the drugs most commonly used aren't used in an RSI (with some exceptions for those that use Succs to paralyze) protocol.

What's further is that we can't operate without the authority of a medical command physician. That means until a MCP gives us the authority (and accepts us under his/her license to do such) to start an IV on an inmate for the purpose of a lethal injection we can't do it. (This is why we can't just run around with IV stuff and meds in out POVs.) And it plays into the larger issue here being that they can't get a doc to sign on to do this.

And I'll disagree with the idea that it's not that big a deal. Technically, no. Starting a line and pushing a button is not a big deal. But it's the end result that's important. Most of us can start lines with our eyes closed in a bouncing truck. But we're not doing it for the purpose of killing a patient.

This is not an issue or attack on anyone who personally feels or believes that capital punishment is good, warranted and justified. This is an issue of medical ethics. And ethics is why this has become an issue. When we started working in EMS we allowed ourselves to be bound by certain ethical guidelines. We cannot, as a profession, excuse ourselves from that when it serves our personal beliefs. And I'd argue that if you do allow yourself to cloud the line between professional and personal ethics then you shouldn't be working in this industry.

-be safe.

Just as a side note, Montgomery County PA is considering allowing etomidate. I think it's before the County EMS council now.

Now back to your regularly scheduled discussion.

And yes, I searched and found nothing quite like this elsewhere in the forums.

I was talking with a guy I know recently who works at a place that schedules their part timers first (based on their availability) and then schedules their full timers in the open spots.

To a certain extent, I can kinda' understand this. Instead of trying to plug holes with part timers you tell the full timers that this is their schedule and go from there. I can see how this might make the scheduling easier.

But on the other hand, it seems a bit hard on the full timers to not have anything set. Even more it would seem to create an environment of discontent in not having anything reliable from week to week and scheduling period to scheduling period. (To help clarify, schedules are done every six weeks for the next six weeks. So they never know more than six weeks in advance when they'll be working.).

I know we have some managers here. Thoughts?

From the rest of you line providers, what're your thoughts if this was how your scheduling was done?

-be safe.

Someone mentioned to read the notice at the top of the forum but that doesn't help a bit.

Can someone please explain what's going on here?

Medication Administration is, in fact, within the scope of practice. It is that those medications are outside of protocols.

Unless you count "Murder" as a Scope of Practice Item.

Well, no. Those medications are out of our scope of pracatice as well. It's not a matter of protocols. EMS based protocols don't come into play here. (Even if they did it would be an issue of going against protocols as no medical director would have a protocol on how to kill someone. Do you want to pay the insurance on that?)

The meds that we push are described to be in our scope. All other meds are out of our scope which is why we don't use them. Don't confuse "scope of practice" with "protocols". They're two different concepts.

-be safe.

Let's see, if doctors won't do it due to ethical standards (I seem to remember something about 'first do no harm...') then what would give an "I" or "P" the right to do it? Aren't we bound by the same ethical standards? If not, why not? If you aren't, then why are you working in this field? Don't we work for MDs...the same one's who are refusing to participate?

If it makes sense to let us do it because it falls within the scope of our training, they why not let an RN do it? Isn't starting an IV within the scope of their training? But oh! Wait! They won't do it either because RNs maintain ethical standards, too! What a coincidence!

Why is it that it is expected that MDs and RNs will be held to certain ethical standards but we won't?

-be safe.

The director, while having a bachelors in "tall tales" and "lying through his teeth", was promoted from within. He really does have a college degree but it's worthless to him and his employees.

At my other job it's hard to say. The main boss in an RN (hospital based service) but I'm not sure about the big boss. His bio doesn't talk about education at all. So I couldn't say.

So the victim doesn't remember who pulled her out? How did the press know it was him? Did he go about and say, "Hey! I pulled that lady from the car!"? Did people point him out and say, "He did it!"? I'm guessing then he stuck around long enough for the press to arrive?

He did what I'd hope any reasonable person would do in terms of helping her out of the vehicle. However, the fact that she doesn't remember it and he's talking to the press leaves a bad taste in my mouth.

My vote is "nice job but you're still a whacker". He'd have gotten the "hero" nod had he just slipped off into crowd without playing up what he did.

-be safe.

Yep...I'm in.