UMSTUDENT

I have a feeling that this series will be ridiculous. Still, this is needed. Emergency! was also grandiose in nature. Most of the country had no idea what a "paramedic" was because they really didn't exist (with a few exceptions).

We as a profession need shows like this; if only to attract interest to the profession. Do I think this show will have the same cultural implications as Emergency? No. I highly doubt this show will have someone with the dedication and expertise of Jim Page. The previews seem to confirm this.

The previews have revealed one redeeming quality. They show "paramedics" engaging in apparent highly technical and rewarding skills. It also shows these providers doing so with a great deal of autonomy. One of the biggest problems with our professions is that we attract too few smart, motivated individuals. A lot of society relegates EMS to a skilled trade a step below firefighters and cops. Very few people realize the very large implications our profession will inevitably have over the next 20-50 years in American society. As we begin preparing for things like pandemic flu, advanced practice, and public health prevention it will help if people know what a "paramedic" is, even if that perception is slightly skewed. While there is some philosophical debate to be had about the merits of obscurity vs. skewed public perception, I think this will help.

Lastly I see one good thing coming from this show: I think people are going to see these so-called paramedics doing some pretty crazy stuff. Some of it will be accurate and others not. Maybe this will make the public demand higher education standards and make their local EMS services accountable for their actions.

The good news is that these previews are from the pilot. This show is being billed as a replacement for the mighty ER. They’ll hopefully invest some money in making the show more believable and less tacky.

I think in order to understand the Maryland phenomenon you have to live here. I personally don't see a problem letting the privates compete, especially since MSP provides an inferior level of service. They provide one cross trained Trooper/Paramedic and function more as a very fast taxi than a high level care provider. The guys that fly for MSP are good, but their model seriously hampers the capability to provide a high level of care.

Things to consider about Maryland:

It is one of the richest states in the country. Our last one billion dollar deficit is a pittance when you compare it to other state's current financial problems. Meanwhile the overall global economic downturn doesn't cause near the damage here as it would elsewhere. Our economy is very service oriented, with a large, if not the majority, of those services focused on the government (military, etc) and scientific sector.

There is an enormous about of brain washing that goes on in this state. MSP has done an excellent job over the years of convincing every voting taxpayer that they have this awesome system. The state seems to flaunt their 8+ helicopter fleet as this grandiose model of fiscal waste.

Marylander's are accustomed to paying higher taxes for higher levels of service. From our roads to our fire departments, government has always been "big" in Maryland. The idea of a private entity controlling anything is just out-of-the-question.

So what does the committee recommend?

The state, during one of the worst global recessions in 80 years, wants to buy 3 brand new helicopters next year at a rough cost of $60 million dollars. Cut one or two bases. Add two pilots to each aircraft, add TAWS and night vision capabilities, and, if the money is available, meet CAMTS accreditation by adding a second paramedic. All of these changes are necessary, but I have some reservations about completely shutting out the private industry.

If MSP continues with replacing the entire fleet they will be the largest government purchaser of helicopters in the U.S. after the United States Government. Think about it.

Whatever happens the system needs to be patient focused. I'm just not sure that is what this has all been about.

A co-worker told me on shift change the other day that he received a newsletter from the NREMT stating that they'll be implementing new name and descriptions for the different certification levels this year.

Most of what he said seemed to follow the recommendations from the National Scope of Practice project, but he did mention that they're changing the name of the NREMT-P to something like a "Nationally Certified Paramedic-NCP," or something of the sorts. The name "Emergency Medical Technician" will be removed from the title and all paramedics will simply be called "paramedics."

Has anyone else received this newsletter? It seems to be off and on among people I work with about whether or not they received it.

Thanks.

There are currently two bills before the Maryland State Senate. Senate Bills SB 650 and SB 764 are in danger of failing to leave committee for vote on the floor of the Senate.

Why does this matter to you? Of particular interest to providers on this forum is SB 764. 764 would create a State Board of Paramedics and hopefully create general professional parity with other healthcare boards within the state (nursing and physicians). Protocol development, licensing standards, etc would be run predominantly by licensed, practicing paramedics/EMTs. The language of the bill requires that the Board (which also has physician members) cooperate with the State Board of Physicians in developing protocol based on evidence-based medicine.

This would be a huge step for Maryland; however, the state fire lobby (Maryland State Fireman's Association) is rallying to block both pieces of legislation. SB 650 would require the state to accept competitive bids from private helicopter services along with bids from MSP for medevac services. It would require any provider of HEMS to follow more stringent FAA standards, and meet CAMTS accreditation. 764 would effectively eliminate MIEMSS and start a state cabinet level department called the "Department of Emergency Services."

A true professional organization would be a big step forward for EMS. If you’re interested, even if you’re not a citizen, voice your professional support via mail. The fire lobby is planning massive rallies in Annapolis on March 3rd at 1 PM to block the bill.

You can see the bill’s status here: http://mlis.state.md.us/2009rs/billfile/SB0764.htm

A full PDF of the bill is attached on the site above. Read it and voice your support in any way you can.

Did you hear this about thirty years ago?

Yeah, I heard they only recently adopted 12-Lead capabilities. Aren't they the same fire department that still carts around wooden ladders?

Whatever. Firemonkey problems. What I think is completely ridiculous is these hospitals who are unwilling or not capable of providing cardiac services (mainly 24/7 PCI) are worried about loosing STEMI patients because "their records won't be available." BS. They just want their revenue at the expense of someone else's life.

Personally I take a offense to this. I worked my ass off for over a year in Intermediate Paramedic class and feel just as qualified as anyone who took a 2 year associated degree course to become a P. Some of us don't have the opportunities to become a P as it does take 2 years to achieve. And my experience at UMBC was a horrible one at that where I experienced the gender biased department head who essentially believed the rumors of one student over the facts. But that is a different story for another time. To say that university trained paramedics are superior to those of us who take a class at our training academy or a hospital is unfair. It is fair to say that people get out of their training what they put into it. If you wander through course work at a university and do not care much for the patho/phys of diseases then you are probably worse off than the student who busted their ass in their academy class to learn as much as they could about everything related to things we see in EMS.

Just my 2 cents worth.... But I do think a paramedic board would be beneficial to the state as a whole...beyond the medivac program which seems to be under a spot light lately.

The EMT-I program in Maryland should be eliminated, period. The "Cardiac Rescue Technician" is one of the biggest problems holding back the Maryland protocols. Furthermore, academy-based EMS education programs are generally a joke.

Your personal history with UM is a totally different story. Out of respect for you I'll choose to let it rest. The people on this forum are usually smart enough to recognize bias when they see it.

Typical rant out of the soverign state of Montgomery.

http://www.hometownannapolis.com/cgi-bin/r...08/12_19-27/GOV

A state senator and representative have introduced a new law for the next session that would require reform for the Maryland State Police Medevac system. The proposed law would also require that the state form a cabinet level position for Emergency Services and a State Board of Paramedics.

Quote: "The senators also propose creating a cabinet-level Department of Emergency Services to streamline numerous oversight agencies, including the Maryland Institute for Emergency Medical Services Systems; Maryland Fire and Rescue Institute; Office of Emergency Preparedness; Maryland Emergency Management Agency; and a new Board of Paramedics."

Almost everything I've seen about this bill says that someone got themselves educated on the issues facing our state and the profession. I feel that a State Board of Paramedics may allow some level of professional recognition on par with nursing and general medicine. A agency that supports and promotes the educational and professional standards of Paramedics would be great.

Around here there is no shortage of paramedics. There is a shortage of competent paramedics.

Most firemonkey jobs seem to want the following:

A) A valid EMT-I or EMT-P license

Ability to pass a rigorous background test

C) Someone with the mental fortitude or stupidity (whichever they find) to put up with 10-18 week fire academy.

http://www.phillyburbs.com/pb-dyn/news/112...08-1644124.html

Major John P. Pryor was killed following a mortar attack in Mosul, Iraq on Christmas Day. Major Pryor was a trauma surgeon with the Hospital of the University of Pennsylvania and a friend of the National Collegiate EMS Foundation. He was serving with the 1st Medical Detachment, Forward Surgical Team based out of Fort Totten, NY.

He leaves behind a wife and three children. Please keep Major Pryor and his family in your prayers.

Dust, it may be a long shot, but were you acquainted with Major Pryor?

My neck of the woods. Hopefully work won't interfere!

Let no one doubt your intelligence and observant vision! You nailed that one! :thumbright:

I certainly understand that. And I wasn't really questioning why they are so creative with schedules with overnight shifts and such. I was more referring to the irregularity of it all. Nothing wrong with 24/48s or 24/72s, as there are many slower systems where this is wholly appropriate. In many rural systems, where medics commute from long distances, they would not be able to attract medics to the agency if they had to make that trip twice a day, several days a week. But what I don't get is how so many managers FAIL to put some consistency in the schedule. If your people have to write their schedule down in order to assure they remember it, something is wrong. And that seems to be an extremely common occurrence in EMS.

The problem here is entirely a firemonkey one. When the head boss-man discussed 12 hour shifts, at least 60% of the current employees had a small stroke. "You mean I have to drive to work more than two days per week? Are you going to pay for my gas?"

Maryland is odd. Because the costs of living are so astronomical, many of the state's paid firefighters and paramedics sometimes live hours away. They like the 24/48 or 24/72 because it gives them two long commutes a week. I'd say it is still a relatively small percentage of people who would be negatively affected by shorter shifts. Maybe 10-15% actually live so far away that it would be detrimental.

I personally would be in favor of a 12 hour schedule. Maybe a 3 on, 4 off- 4 on, 3 off. I think most of us are entirely two dangerous after 20 hours of work. Anyway, I caught wind of the ridiculousness that is apparently being considered. Something about a 4 FTE shift where you would work your 24 hour shift, have three days off, followed by a 16 hour shift that would start at some horrible, constantly rotating time (potentially as ridiculous as 2-4 AM). The weeks would slowly rotate so that your 24 hour and 16 hour shifts would move forward in the week as time progresses.

Ugh...

I know a lot of people here have worked a variety of EMS shifts over their many years of service. I need help trying to figure out a "secret" schedule change that is about to occur where I work.

Here's the scoop:

I work for a fire-based 9-1-1 system. The system is interesting in that it employs both fire medics (who have to meet FLSA 7K standards), but also Paramedics who specialize in EMS only (these are non-exempt, 40 hour per week employees). The system is primarily designed around the paramedic specialists and this new scheduling change would effect the majority of the work force.

We currently work 20 hrs on, 52 hours off-on a rotating shift. The shift has a Kelley day (day off where you would normally work) every third week like a traditional 24/48. My supervisor recently told me that they will be going to a shift that will meet the following criterion:

A) Employees will only work two days per week.

The Kelley day is eliminated.

C)The shift will be rotating.

D)There will be no guaranteed overtime built into the schedule. This means that employees will only work 40 hours per week OR will have a short week every so often that will make-up for the OT paid out by the organization. He seemed to hint that the latter is the answer.

This organization is very secretive due to governmental policy. They really never converse with their staff regarding staffing issues and changes are sudden and without notice. I for the life-of-me can't think of an FTE schedule that would meet the above requirements without some form of overtime. This is especially troubling since I'm trying to make some very current decisions regarding my future. I'd appreciate the collective minds and experience of the people on the forum. A small riddle to solve that would greatly help me out.

The UAW really isn't the problem here. I have a fresh insight into the auto industry mainly because I have friends and family members on both sides of the argument: management and union.

True, the GM workers who make $29 an hour after a few years on the job need a reduction to reasonable pay terms. Please be assured that most UAW workers do not make that much money.

The real problem with the American auto industry is crappy management who push crappy products. I mean, seriously. Do some serious reading on the current problem and you'll really see what has destroyed this industry: poorly engineered, low quality vehicles. The American auto makers basically left innovation aside and left the American public to test their products. They never listened to the experts who spouted about the inevitable increase in foreign demand for oil, never cared to raise their fuel efficiency standards, and they let the Japanese get 7 years ahead of them in hybrid powertrain technology! Furthermore the American "way" of manufacturing is grossly inefficient and allows for little input from the guys and gals who actually build the cars and trucks we drive: the workers. Only 8-10% of the cost of a vehicle is in labor. 8-10%! Compare that costs to our industry where 50-60% (minimum) of our daily costs are purely in payroll. Compare it to any service based company that currently fuels our economic engine.

The true economics of the auto industry are too far fetched for most Americans to understand. In many regards Detroit created the post-war American middle class. There are entire parts of this country whose economy floats along day-to-day on the "inflated" wages that UAW workers make. Entire generations of kids have been able to go to college and gain the skills their parents didn't have because of the UAW wage. Unfortunately it is a dying breed of jobs and the people who currently work in these positions bridge the gap between our manufacturing past and the present service oriented, build nothing, sell nothing, credit swap economy that we sustain.

I think we must remember that the purpose of any economic transaction is to produce something that can inturn be sold for cash. Service jobs like healthcare really only serve to sustain an economy that produces some form of tangible or intellectual product. When we cease to do this as a country we risk severely stunting our place in a global economy.

http://www.cnn.com/video/#/video/us/2008/1...d.in.death.wjla

Yeah, DC needs to be completely overhauled. If I were the Rosembaum family I'd be livid...

Separate EMS from fire Mayor Fenty. Do what you campaigned on.

So it's one of those "insert laugh here" jokes. I'm afraid I just don't get it.

What was your interpretation? I'm not emotionally attached to the comment, I just want to know the intention behind the words typed.

It was a funny insult. I thought you were making a dumb firemonkey comment, but you've since proven you're not a troll.

Context of comment: We get the occasional firemonkey that gets on here and spews stupid, uneducated comments about how the fire service is great, big shiny fire trucks are great, and EMS should be thankful that they even get to breath the same air each day. You seem to actually be contributing in a positive way, so my bad.

British Navy Commander James Bond is reputed to be on extended detached duty working for MI-6, with a "Double Oh" designation as a "Licence to kill". You've probably heard of "007. Bond. James Bond".

We admit that there is a CIA, but the UK denies the existence of a real MI-6. Therefore, there might not actually be such, but the activities of British spies might be under the real MI-5.

(Strange. The Spell check is asking if I meant Chia Pet, as opposed to the Central Intelligence Agency. CIA)

They deny their existence, huh?

http://www.sis.gov.uk/output/about-us.html

Yeah, they've openly acknowledged their existence for some time now.

Further more... http://www.mi5.gov.uk/

Forgive me, I'm not quite sure I understand what you are saying.

Exactly. Don't worry about it. The amount of waste on fire service equipment is astounding while most EMS programs scrape by on a day-to-day basis. There are too many fire departments getting too many shiny new fire engines while EMS, which runs 80% of the calls in this country, gets shafted. All I'm saying.

You have to love the Union. I wonder how pissed they will be when they privatize the EMS ?

Obvioiusly from Canada (no offense, just a testament to geographical distance). They won't. There will be no privatization of EMS in the District of Columbia. Too many polticial road blocks to that ever being brought up. During the Commision's investigation into how "best" to improve DC, I only ever remember reading about them discussing the Pinnelas County, FL SunStar system (PUM). I think the closest they ever got to "listening" to a third-service EMS agency was Boston EMS, which is run by the City of Boston.

This could be a great tool for the ER, but it really doesn't mean much to EMS. 15 minutes is too long to wait around and see if there is a problem. Most agencies can have their patients to the ER by then. But, if this saliva test really does work, than it will make bank because alot of people do have silent heartattacks.

I imagine the time can made faster. Given advances in computer technology, the only time limitation I see is the time it takes for the actual chemical assay to occur. The computer reading the results is probably fairly instant.

Besides, 15 minutes is not meaningless. Most calls from time of contact to the time they reach the ED are probably in the realm of at least 20 minutes. In rural/suburban settings like where I work you can easily spend 20 minutes on scene performing a 12-Lead, establishing an IV, and extricating from the house. We have this belief in EMS that we need to run, run, run to the hospital, when the opposite is actually quite true. The time saved on scene from taking a saliva swab that could confirm elevated cardiac enzymes in tremendous.

Like most of our problems, we would just need to re-educate.

Ooooh! I like this! As soon as I am done introducing myself -- before I even take vitals -- I'm getting a sputum sample and starting the process. By the time it's done, I will have vitals, a full history and physical, a 12-lead, and oxygen and IV established. At that point, I know whether or not I need to be headed to the cath-lab. Man, no matter how much this costs, it could save millions of dollars a year, and countless lives, as well as a lot of paramedic embarrassment.

Total win! :thumbright:

Agreed. Add to it the advances in field diagnostic technology. Dang engineers and their new fangled technology!

Definitely a believer that technology may well cause us to advance into the future faster than our own efforts.

This idiot was elected on a platform of SEPARATING Fire and EMS.

DC is a mess. Probably the worst or one of the worst systems in the country. Period. There have been some improvements, but still a mess.

DC suffers from the fact that every metropolitan system around them is an integrated, well-funded fire-based system. So of course everyone wants to jump on the bandwagon when the solution has always been to separate the two.

The equivalent of the FBI, ICE, ATF, DEA, DHS, Bureau of Prisons, NSA, and every police department in the country, all run by one agency.

Not entirely true. The British equivalent of the FBI would be the aforementioned MI 5 (military intelligence, section 5) also known as the Security Service. I do believe that MI5 is actually overseen by Home Office, sort-of like our FBI is overseen by the Justice Department.

MI6 is the British Secret Intelligence Service (SIS) or the equivalent of the American CIA.

Well considering I am a firemonkey...

In a small community like the one I work in, we can use all the help we can get. And so far, we have caught a few good breaks. I don't know the funding protocols behind other city/county/state run EMS departments, but I assume they are more eligible for federal/state support than a privately owned ambulance company/corporation. The state of Alaska has been very generous in terms of EMS support.

As for overpriced fire response vehicles? We don't set the price tag. When it comes to being prepared in a place where you are your only additional resources, doing the job right can cost a lot of money.

Two words...Sarah Palin. I wish Alaska would fall back into obscurity.

Hey guys,

I wanted to make everyone aware of something on President-Elect Obama's transition website (www.change.gov).

http://www.change.gov/page/s/yourvision

On the above page you can share your "ideas" with the incoming administration. You can even upload a video or photo for the transition team to review. Now I know that the chances of everyone of these things being watched or read is slim, but hey...worth a shot, right?

A lot of us complain on here constantly about poor federal policies or how the Feds put more stock in fire suppression that in actually fixing the EMS ills of this country. Here is your chance. I encourage everyone who has ever sought "change" to write and tell your story. Tell them what being a paramedic in this country is like. If you have a camera, tape what you do (remember privacy concerns). Highlight the problems in our profession and promote real change:

1) Highlight the need for a "real" federal entity. We need someone who tracks statistics, provides funds, and fights for better reimbursement.

2) Bring back federal dollars for substantive EMS research.

3) Promote the need for higher EMS educational standards. Ask that federal dollars be made available to start the next generation of college and university-based education programs.

4) Promote EMS as a health care profession. Get it out of public safety!

5)Fight for better reimbursement from Medicare/Medicaid and any future Obama/Biden changes to the current entitlement programs.

An engine (pumper) company for road blockade? Not the (Ladder) truck company?

I guess it depends on what jurisdiction the incident being responded to is in.

Yeah, around here the standard dispatch goes something like this:

1 Ambulance

1 Medic Unit (If Chase Car System)

1 Engine

1 Rescue Squad or Rescue Engine

In the metro systems you'll find ladder trucks or quints responding to MVCs, especially if they're equipped with basic extrication equipment.