AnthonyM83

Don't punt a skunk either...there was a football player at my school who did that....bad idea.

This might be why he got pissed off and started making you look bad. For the sake of the patient watching the exchange, I would have just explained the situation and told him why it was appropriate. IF he continued, I would point out that he was not qualified (again, for the sake of the patient, so he'd trust me over him) and then respectfully ask him to step away and let you treat, since the treatment responsibility laid on you. As far as the O2, it seemd appropriate, but I'm not even a 'practicing' EMT, so I'll leave that to the other guys.

Eh, every now and then medics do get treated that way, unfortunately. You're right it does send out a certain portrayal, but all shows do this. Reminds me of how cop shows always have the city cops and the Feds at odds. On my first police ride-along as a teen, we worked a bank robbery and someone mentioned the Feds were here. My immediate thought was, "oh, man, they're gonna ruin the case" b/c it had been so engrained from television. But the other cop's response was, "Oh, cool? Is so and so there? Last time we we went out for drinks." They proceed to share stories about fun times with the Feds and how they should be paid more". Goes to show how television really does mold us, especially kids.

What the heck are you talking about? She's totally a hero in this episode, despite her ditzy immature personality (they make it a point that she's young). She puts her hand INSIDE patient to save his LIFe b/c that's her priority, despite her partner disagreeing with her. Saying she's not qualified to be in the OR is nervous/excited chatter as she humbles herselves to the docs, so what. Then she actually STAYS in the room even though the other doctor bails out on her. She's scared and shaking, not a naturally strong personality, brand new medic, but she stays and manages. That scene was a diss on the coward doctor. I don't know how you got out of it that he's more important just b/c he rushes out saying "I've got kids". The scene wasn't supposed to make viewers go 'oh, he's more important, she's more expendable'. It's supposed to make them go, "What a jerk! I hope he gets fired or drinks himself to death (my friend actually IMed that comment during the episode). When the episode first started I worried it might be a medic bashing scene, but it turned out to be exactly the opposite. Then again, maybe people just see what they're looking to see... Edit: The doctor showing her how to bag someone was slightly degrading, but you might figure she knew how to do it, but was so nervous she was doing it to fast (b/c her hand was on a bomb), she he was remindeded to keep it constant. On screen it came off as a good transition and I think the viewers to busy realizing the jerk doctor was going to bail ship on her.

Could it be an issue of medics doing stay and play, while BLS have limited options so more likely to scoop and run?

Anthony was killed by illegal chokehold applied by former Police Officer Francis X Livoti Who woulda guessed

Official Answer: Scene unsafe, wait for resources. Real Answer: I'd be pulling people out of the burning car if possible and moving everyone away from the building/fire/truck.

If someone were moderating this debate, I think they'd say it would now be up to someone to find quality journal articles "scientifically conclude that field clearance safely eliminates unnecessary immobilization AND assures that no spinal injuries are not immobilized" IF they wanted to disprove Dustdevil...not the other way around. (Sorry...just trying to follow debate w/o head exploding.)

I stopped reading after you guys started posting those two-hour posts, but Dustdevil was making pretty logical sense to me. It seemed people were replying to things he didn't say and then making him defend himself on stuff he shouldn't have to be in the first place. These kinds of responses seem to be common on these types of boards...someone will mention an ox meter and someone always somehow pops in to accuse the person of relying solely on the ox meter and not the overall patient (when I'm sure he knew that, but that wasn't his question). Or a personal example, when I posted that searching patient would technically be assault, just as fyi, but one should do what they have to in order to keep safe...people replied by saying I was going to get hurt with that type thinking...even though I had just said advocated doing what you need to to stay safe. It's like people don't read sometimes...they just start up another argument that they can easily win. It seems to happen a lot so maybe it's just human nature...I dunno. It's fine if you're doing it to just point something out, but when you make it seem like it's a fault in the other person, the other person will get defensive, of course.

Do you think EMTs' "rationale" and "common sense" is sufficient for them to make the determination?

I'd say we don't have enough information. You need a study done where both the Malaysia and New Mexico hospitals both held c-spine and then both didn't hold c-spine. The results could be attributed to one hospital getting worse type of injuries in the first place (or seatbelt laws or any number of other factors)

You could try contacting the Palo Alto Fire Department in Palo Alto, CA. They had a GREAT program. Top of the line explorers. Very knowledgeable and driven. They started out as a First Aid/CPR/Disaster Response club in high school. They got publicity when someone put a cherry bomb in a water fountain or somethiing. Made a big explosion and they came to the rescue. I always wanted to join, but didn't have time. They recently were in the paper for sexual misconduct, though, so might not be active, but they could probably still give you good suggestions. Dustdevil brings up a good point. Sexual misconduct is pretty much guaranteed to happen unless you guys are hyperparanoid about it. I know a lot of officer and explorers who have had inappropriate things going on and am now jaded. It's going to happen anywhere and it doesn't matter how "good" a people the advisors are. I think it's a worthwhile program is properly regulated, though. Your local boy scout council will probably have an explorer rep that can help you start one up. Trench, what's a level 3 explorer? I think that's just a local designation....

OMG, I hate that. If a cell phone goes off in class you rush to turn it off immediately! And then you don't let it happen ever again. I don't know how I keep having people in various classes whose cell always rings. Familiarize yourself with your phone and make it second nature to silence it as you walk into any classroom.

I agree that if we did away with EMTBs, we'd have a problem getting new people in, including smart people. Perhaps if the main focus was increasing paramedic education and then reducing the cases were EMTBs can work alone without someone with the advanced schooling degrees, that might help. You can't just take them away, though. They're the backbone of the service and many won't have the resources/desire/long-term commitment to job to upgrade. Another important issue: after reading Ace's plan (which seems like a good one for most part) Where is the funding for all this going to come from? Is AMR going to pay to put their employees through more training? Is every city/county going to put out more money? Private companies are incredibly stingy as it is (from what I've heard) and public EMS services seem to always be lacking in personnel and proper equipment. How would this change get pulled off without a command and assistance from state or federal government?

That'd be a good list. I'm going to start a new thread on that!

Ace, Some say it's the communicator's job to get the information across to the receiver. If so, the sender must callibrate for the audience. On a message board with a dozen messages being posted every hour, with readers quickly choosing what post may be a good read, you're not going to get too many replies to such a long post, even if the information really is there.

How do we make EMTB job attractive to someone career minded? Will the job change if the EMTB has to have an associate's degree? How will that attractiveness come?

Wow after spending a day at at the local firehouse and hearing the trainers talk about the horror stories of their Paramedic II applicants about their what private compnaies will do to get their way, I'm starting to think it really will take an act from God. Or rather an act from higher government. Maybe something needs to be horribly wrong (a mistake leading to media scandle) or there needs to be a few studies done and another White Paper written on the state of things.

Nate's right. That's actually one of the main reasons people decide to become doctors (among others of course). There'd have to be a system to actually measure quality care. The last thing we'd want are people who don't care and are doing this just for the money (i think...hmm)

I think the theory is that people will stay in the field longer, decreasing turnover rate, if it's harder to get into the field. Another theory is that if you have to put a lot into becoming an EMTB, you're more likely to go all the way and become an EMTP, so the Basic to Paramedic ratio might change (would ambulance companies want to pay more paramedics than emts?) I think there's just so many factors, we need to see what the most successful states and/or counties are doing and adopt their model, slowly to work out stuff.

I think this is another case wehre every teacher needs to callibrate on the type of students coming in and perhaps the type of training instition. Are you going to have a lot of young kids with little academic experience who need to be heavily guided to help them succeed? Are you running an advanced class where students are used to getting a lot of assignments and know how to balance stuff out? Is this supposed to be a really difficult, perhaps elite, class that will be going above and beyond? A good teacher will try to balance things out by giving a lot of verbal information in class, having it all backed up in the reading, and also backed up by a lot of hands on activities (presentations, discussions, scenarios). I personally learned almost exclusivly by paying rapt attention in class and that was enough to ace my tests. Others needed to have the book in front of them and see everything relation to everything else. Others needed to write it out for themselves. If your class is good enough, they'll figure out their style themselves. If not, you need to help them. That's just my take on it as a student.

I don't think it's a sign of instructor/student relationship, though perhaps a breakdown of cultural customs. The only kind of hat I've ever worn is a cap and we only had to remove them through 8th grade (before I even started wearing them), not high school or college. It went away, just like asking permission to go to the bathroom in elementary school. I think actions should (for the most part) be judged on intentions. I show my respect for my teachers by following their rules. If it's specifically a no-hat rule and I respected them, I would never wear a hat. I show respect by following their wishes, speaking well of them, putting extra effort into their class, and being honest.

There's a good reason to require some sort of degree. It shows they've entered the higher education system and were resourceful enough to survive it and have experience in successful studying (even if they needed outside help in reaching that point).

I don't get it. Do you mean the cap, as in the brim, is a safety hazard? Or are you referring to a dress code for professional reasons? If the latter, then I ask if a police officer or a trauma surgeon is any less effective in skills wearing jeans and a t-shirt (provided they have all their tools). Perhaps psychologically/subconsciously they are (which could actually be a valid reason), but for the most part I'd say no. Of course, there's something to be said for having a super strict, almost academy style of training, THEN easing up on things. PS I forgot to mention this in my original post in this thread, but if I were to go to a convention, you probably could pick me out as the EMTB, but only b/c that's the only place I wear a company shirt...among other EMTs...I don't dress in company polo shirts & baseball caps outside of work, usually. PPS Some of my posts might seem like they're going both ways on this issue...mainly b/c I want to put out possible thoughts/counter thoughts. I don't actually know what stance or combination of stances is best there. Perhaps surveying different schools, student demographics, and then career success rates would be bet. Like how school alumni offices keep track of their graduates.

While it'd be great to have a deeper understanding, I'm not sure when it will be used under an EMT-Baisc/BLS scope of practice. If it's extra information, just for the sake of showing you're dedicated, you want to understand the big picture, and prepare you for ALS training, then I'd go along with that. It would be similar to med students needing to take calculus and organic chemistry in undergrad, then usually never use it again in their careers. Shows you're smart enough, have the dedication, interest, and commitment. If we did this, I think it might improve the field. BUT it COULD also be considered extra information that might never be used and confuse the student. An EMTB/BLS, a technician, will not need to know about angiotensinogen to angiotensin I to II and ADH release, and so on. We have a pretty thick book, Emergency Care and Transportation of the Sick and Injured, 9th ed, supposedly the most inclusvie one being used out there (?), but from what I've gotten from the book and class is we're not making heavy analysis or conclusions. We're seeing these s/s under these circumstances, so we then do this set of symptoms. Most critical thinking involves scene safety, patient interaction, obtaining history, working in difficult environments, improvising extrications. At least this is the impression I'm getting...what do experienced people think on this subtopic?