b.anderson

I appreciate the advice, and agree with you. I'll use this as incentive to get some more practice in and learn more. Thanks for the warm welcome! I've been enjoying my experience here so far. Well said. I can't say I envy your experience as a patient, but I can appreciate it as an informative experience. Entonox isn't the best, and there are much better alternatives that you've described. We were given the opportunity to try it in class and it certainly doesn't get rid of pain, but it as you said does disassociate you from it (though, my experience was only with newly inflicted pain, not withstanding pain. I doubt it makes much difference though). Though, I am thankful that BLS in BC have access to it. I'd have to assume that some pain management is better than none. I've discussed this with some EMT-B friends from the US. Most of them don't have access to it (in fact none that I know actually have access to it) even though it's widespread in Canada and in the UK. ALS is definitely better equip to deal with pain management. I can't disagree with that. I'm not sure about fracture management however, I'm only somewhat familiar with the BC EMA fracture management protocol and it's the same across the board for EMR, PCP and ACP levels. Link to the relevant protocol here. So from what I gather the point is basically that ALS can provide better pain management thus better fracture/orthopedic injury management? As a side note (for unfamiliar or not in BC), ACP's in BC have an additional pain management protocol with Morphine and Nitrous Oxide. I'm not sure if they have anything else though, the protocol I looked at only included Morphine and Nitrous Oxide in addition to the separate pain management with Entonox protocol. Forgive the long winded post. All the best, B. Anderson

Everyone starts somewhere, and we certainly aren't perfect. I also admire and thank you for helping him out. If all works out, that'll be one more dedicated health care professional. Best of luck to the both of you. I agree, the EMS profession can seem intimidating from the beginning (albeit, I'm still beginning myself) and it might be so intimidating for some to push them away from it all together. You have to remember that EMS is about the patients and the care they receive. When you enter a profession where real human lives are on the line, one has to expect a bit of hard honesty. At least that's how I look at it. All the best, B. Anderson

I'm a bit late to post here, but I thought I'd jump in and give my opinion from a student perspective. As a disclaimer though, my only knowledge of what the NREMT exams consist of are from friends I have from the United States (I live in Canada). So take what you want from this. I can say with confidence that many people have been able to pass the NREMT-B exams. I don't have an opinion of the exam itself as I've never taken it. Obviously however, it's not impossible. I know a few people that simply have trouble with written exams, no matter the format or subject matter. I've read over a few NREMT-B practice tests a while back a friend sent me the link to, just to see what the similiarities and differences are to the exams in BC. It seemed quite simplistic, but I've never had trouble with written exams. If what you've said is true, that your trouble with the exam is focused more on how it's presented, perhaps you could learn more about the common mistakes people make on multiple choice questions (any M/C questions, not just those EMS related) and work from there. I found this non-EMS resource from a University of Wisconsin geography class. It provides some good information to those that have trouble with multiple choice exams. Don't stop with that one only however, I'm sure there are other resources available somewhere as well. http://www.uwec.edu/geography/ivogeler/multiple.htm I digress however, Dwayne made some very good points as did many of the others. Your attitude seems like you're looking to blame an established exam for your failure. Don't blame the exam or anything else. Focus on the facts: you failed, now you have to figure out why you failed, correct the problems (ie., study), and pass it the next time around. I remember something one of my instructors told me a while back: "If you find the answer, use it unless you are absolutely sure it's not the correct one. We're wired to get it right the first time." Which is absolutely true. Good luck on the exam the next time around! All the best, B. Anderson

From a post-BLS student perspective: I agree. I found that during the EMR course (equivalent to EMT-B in Washington) there was a strong focus on respiratory, and cardiac emergencies. In whatever spare time we had we'd talk about splinting and throw in some pain management stuff as well. Luckily, in BC, EMR's and above are licensed to use Entonox for pain management. It's difficult to mess up, and the only way you can is by failing to rule out the contraindications. Basically, 50% nitrous oxide and 50% oxygen mixed together, and self-administered by the pt. with a bite stick they suck on to get it out. It works quite well and gives us BLS folks something to work with at least--though it's certainly not as good as anything that can be pushed through an IV. I know it's not commonly used in the United States, if at all. Here's the drug monograph for anyone who isn't familiar with it: http://www.paramedic...mc/Entonox.html Even though we're licensed to use it, it's not emphasized during the course work. I find that, at least in my experience emphasis is put on "the other stuff": cardiac, respiratory, spinal, patient assessments, etc. It doesn't take much experience to realize that a pt's main concern is simply when their pain will be gone in most trauma and medical cases. That's not to say emphasis should be removed from any other topics, but I do find pain management is something that's rushed through, at least in the EMR courses. I can't say anything for EMT-B courses, or the NR. As far as splinting and limb management goes, I'm only really in a position to say that just like pain management, splinting and limb management should have more emphasis. At times it can be just as important as proper spinal management, especially in pt's with a polytraumatic MOI. (I recently learned that term here on emtCity--so thanks!) I'll be the first to admit that I personally am not the best with splinting, and with all sincerity, I hope I'm not the best in any other areas either. It would be a sad day for EMS. Faux self-loathing aside however: I agree more should be done in the way of educating students of the importance of pain management and splinting. I'm only familiar with the BLS ways of dealing with orthopedic injuries, so I can't form an educated opinion on if they should be dealt with in any more capacity than BLS. I'll trust the far more educated though that there are likely better ways to deal with said injuries apart from the way BLS is taught. Speaking of the far more educated: what are some common things that irk you when you see BLS managing orthopedic injuries? Of course within the limited and varied protocols we have to work with, I'd like to do the best I can. All the best, B. Anderson P.S. Asysin2leads, accept my best wishes for a full recovery.

I appreciate the warm welcome! I look forward to gaining more knowledge in reading and participating here. Best, B. Anderson

Hi everyone, I'd like to introduce myself to everyone on the forum here. I ran across it the other day and decided to join. I found many of the threads to be supportive which is the opposite of many other forums I've seen related to EMS, but I don't mean to generalize. I'm a 17-year-old Emergency Medical Responder (it's an equivalent to Washington's EMT- from British Columbia, Canada. Currently completing my secondary education before being eligible to apply to the Primary Care Paramedic program over here. I have my eyes focused on a career as a paramedic. Currently, I plan on obtaining a PCP certification and licencing, and head back to complete the ACP program once I meet the additional pre-requisites. I haven't decided if CCP would be for me yet however. Most of the instructors and paramedics I've spoke to have said the majority of CCPs in BC do life flight hospital transfers--I'd like to work on the road, though it's not completely out of the question for me and I certainly wouldn't mind the additional knowledge and education that came along with it. I'm rather inexperienced, the two gunshot wounds that were drawn on with sharpies during the EMR course notwithstanding. Due to my age, opportunity to gain real world experience is limited. I look forward to learning more, and speaking with everyone here. Best, B. Anderson