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WestMetroMedic

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Everything posted by WestMetroMedic

  1. Does anyone out there have a template that they use for care plans that are disseminated to field crews on high-utilizer patients to help assist with clinical decision making? Trying to deploy a care plan template here and not super interested in reinventing the wheel if it already exists.
  2. Ill admit, its a corny line, but in my defense, people retire from Hennepin, everywhere else sees people move on towards "greener pastures" or providers leave ems because their spine exploded. Sent from my DROID RAZR using Tapatalk 2
  3. http://www.thedailyshow.com/watch/mon-may-9-2011/minneapolis-is-the-new-gay I suppose it is worth mentioning that we only have ONE mobile home park...
  4. I completed the Hennepin Technical College program last semester and had an overall positive experience, but there is much work to be done still. Hennepin Tech's program is a 13 semester credit course which involves 4 hours of classroom once a week for 1 semester, in addition to a minimum of 200 clinical hours. I still am building my clinical experience, as I want to tailor it to the hospital that my EMS is affiliated with. I found that much of the program was focused on changing how you think. As a traditional paramedic, our focus is on taking people to the hospital, versus the focus of this program is keeping patients out of the hospital and from ever dealing with the traditional EMS system. This will be useful to help deal more rapidly with the needs of hospitals dealing with new medicare rules involving readmission and many private insurers moving to an Accountable Care Organization (ACO) payor model. Deployment of a program will be different in every location it is employed. In a rural setting, you will find success using the Australian model, which brings a Paramedic with primary care education and relationships and places them in communities that have poor primary care access due to a lack of providers. This also allows these rural areas to have access to an ALS provider for their 999 response, that they would not have been able to justify before. In my system, which is a large urban center, our intention is to deploy it to deal with ACO payors, readmission issues, provide home care to clients who do not qualify for RN home care and act as an adjuct to traditional EMS by providing advanced wound care and indwelling device management at pt side versus, for example, the $3000 it costs to bring a person in from a nursing home to have a foley put back in with a coude(sp?). We also want to use mimick to successes that MedStar in Fort Worth, TX has had in dealing with high volume 911/ED users. MedStar runs an excellent program, and they don't have any selfish concerns about people copying their program, in fact, they are completely transparent and will answer any question you may have regarding how they deply their community health program. We also seen interaction with corporate health programs, public schools and homeless communities to be excellent avenues for this business arm. The education level is a concern that I have, but until EMS provider start policing themselves and pushing the EMT-Paramedic to at least the BS education level (heck even a AAS standard is a start), we will continue to have difficulty justifying our existence. Conversely, using the John Puryear philosiphy, what is a degree beside a piece of paper saying you sat through a bunch of silly classes that are not going to make you any better of a provider. At the end of the day, this isn't for everyone, and I think in order to obtain this education, you must have proven yourself to be a model of didactic excellence that is able to integrate it with outstanding interpersonal skills.
  5. as long as you come up with a social security number that is nine numbers long and no letters or characters, I don't see any reason they wouldn't see you as legit... Actually, we have a couple foreigners here. A Kiwi, a couple Canadians, a Korean and some other ethnicity completing our rainbow of diversity.
  6. Hennepin EMS is hiring at least 6 FT paramedics (40hrs/week) for a February or March start date. As a service of Hennepin County Medical Center, an academic Level 1 Adult and Pediatric trauma center located in the urban core of Minneapolis, we serve 800,000 residents and a week day population of 1.2 million in 14 unique municipalities. Approximately 135 full time Paramedics are supported by 15 EMT-EMD dispatchers, 10 supervisors, 4 stock staff and 5 support and billing staff members. Last year, we completed over 64,000 encounters, with a UHU of around 0.44, but this is a staffing push to reduce to 0.38 (We added 20 additional positions last year to reduce UHU, but a 10% volume increase was seen). Aggressive, industry leading protocols and research commitments help our paramedics perform excellent pre-hospital care in a system that ONLY does 911 response (NO IFT's). We are the market wage driver for the Minneapolis and St. Paul 7 county metro area and are enrolled in the state Police and Fire pension (PERA) that vests at 20 years and is 100% in 33 years. In addition to the intial uniform issue (~$1,000 worth), a year $500 uniform allowance is given. 27 Road Rescue Ultramedic ambulances on Ford E350 V10 gasoline chassis that are nearly all equipped with Stryker's PowerLOAD system. We have fully deployed LUCAS2, Zoll E-Series (for another 2-3 years), TriTech's VisiCAD, OPEN's SafetyPAD tablet based ePCR, Stryker StairPRO chairs, and Motorola's series of APX portable and mobile radios on a 99% in-building portable coverage P25 trunked system. Out of state applicants can often Skype interview and receive serious consideration (1/2 of last hire group was out of state). Hennepin EMS is a career, everything else is a job.
  7. If you ever get to the big city, say hi to the brown shirt Hennepin county medics... We are a pretty nice bunch...
  8. Is that not standard? I guess i have never been in an ambulance that didn't have it, and i have worked for some cheap services. We need it in Minnesota to deal with the -30 f cold and 105 f heat.
  9. It's generally better for the vehicle anyways to throw it into high idle...
  10. I have been starting 20 gauge IV's only this month for breast cancer awareness.
  11. On the west side of the Minneapolis St.Paul metro area, all of the services participate in an equipment sharing consortium. We all share the same LBBs and traction splints. We have also realized that one LUCAS(2) back plate is just like every other LUCAS back plate, so we really don't care. The level I that i work for will mail equipment back to its owners although i when equipment is marked with "CFD" it is really a crap shoot so i think that the first CFD on our mailing list gets themselves a new LBB.
  12. Do you get the reemergence effect with the lower doses of Ketamine typically associated with pain control? We recently added a Ketamine option as an adjunct to analgesia at a dose of 0.5mg/kg. Our medical director cautioned against it citing cost and the associated hospital course, but they never mentioned anything about administering a benzo with it like they do with our behavioral health doses of 2 mg/kg IV or 5mg/kg IM.
  13. The last group of people we hired had bachelors degrees in international business, media arts, and two other random things. None of then had a science degree. What i think a degree says about you is not specifically your education base but more so that you jumped through the hoops of getting a bachelors degree and spent enough time to finish it, which is an accomplishment as far as i am concerned. I'm going back to school this fall 8 years after finishing my associates degree to finish my bachelors and i although i have no intention of leaving this field, I'm getting a degree in marketing, just cause you never know when your spine is gonna explode. I think the basketweaving bachelors degree should hold just as much weight as a biology degree. Either way, you have more education than 90% of your EMS peers.
  14. I dont know much about how everything rolls down there, but i spent 2 weeks in Februrary taking my CCEMT-P at Careflite, and was very impressed with the educators they used and the Cadaver Lab at UTSW. I would, without question, drive 1000 miles down to Texas again to take another advanced certification course. There were 5 people in the class from TX (1 Careflite, 3 Scott&White and 1 from some suburb of Houston), and I was shocked at how decent EMS in Texas generally is with a couple exceptions, not at all what I expected. I kinda figured that Texas EMS was simply done on horseback, and transports accomplished by lasooing (Sp?) a patient and dragging them into the hospital Old West style... I also learned that the acronym HFD for Houston, actually stands for "Home For Dummies."
  15. This is very welcome development... I first heard official-ish word of this development while taking a PHTLS course last year. Instead of using a scoop stretcher, my service keeps using a technology we have used for 120 years of our existence, "canvas and poles." As archaic as it looks, this system is incredibly adaptable, ergonomically better than all other options, and markedly more comfortable for our customers. Essentially all it is, are 2 aluminum poles with wood handles that we have custom made that fit in a sheath on either side of the custom made canvas. the canvas covers are about $23 USD each and i think we get about 10 uses out of each cover before they are donated to the goodwill. In the MSP area, we have the luxury of having nearly every hospital use the same laundry service, so we just get them routed back to us after laundering. Excess of 500 pounds can be carried by these. We get a lot of crap from other services who don't realize how awesome these are, but they iz just haters.
  16. I have informed's critical care program on my Droid. I bought it to replace the plastic flip book of theirs that i had gotten many years ago. I really like it. Easy to use, good diagrams and a decent little tool to have in my pocket. I think it was $8.
  17. Universities are always a good place to look. Sporting venues also may be a good route. The red cross takes care of our professional hockey team and out pro football and baseball teams have their own volunteer groups.
  18. When it comes to professional sports, this is what i know - MLB requires an ALS crew with transporting capabilities dedicated to the field, we also assign one medic to work with their first aid team in the stands. They have about 20 volunteer BLS providers at each game. NFL requires 3 ALS providers with transport capabilities on the field in addition to the NFL employed physicians. We also staff another dedicated dual medic crew to the stands to augment the 30ish volunteer BLS providers. NBA and WNBA require an ALS unit for the court in addition to their paid BLS providers. I spent 6 years volunteering with a NCAA division 1 universities BLS EMS and we generally had a transporting until at every sporting event, but IIRC, mens hockey was the only sport that required a transporting unit. Other wise we would staff with about 4-6 people per event. Football also required a transporting unit, but they require ALS, which is provided by my current service. Basketball required a physican on scene.
  19. I like to open with one of the following - Well that isn't normal. That floor doesn't look very comfortable. What kind of predicament have you got yourself into today? Can I see your ID and medical card?
  20. For the first 3 months of me being a medic, I kept asking my self, "who's stupid idea was it to let me be a paramedic?!" Then there was one call that, although it didn't go great, everything seemed to click there after. Fake it until you make it... I've been doing it for 9 years now...
  21. In am effort to reduce weight dragged in on every call, we have a couple different bags Blue bag - this is our medical bag, having all of our meds in it, IV access, IO access, vomit bags hold forms, vital sign stuff, etc. Red bag - this is our trauma bag having trauma stuff obviously, vital signs stuff, vomit bags, BLS airway and IV access stuff and med admin stuff (in case we give morphine at the patient side). Light weight and fully inclusive. Green bag - everything airway. King LTS, ETT, BLS airway, v-vac suction, and that kinda stuff. Turquoise bag - OB bag. That's all I have to say about that. LUCAS2 - self explanatory, spare battery, suction cup and straps. Klunky orange oxygen thing - or first responders bring in oxygen already, so no need to carry it in ourselves. In case though. All of our bags are different colors because if your need more equipment on a call, you often get the best results when you ask a first responder to grab the green bag instead of the airway bag. Sent from my DROID RAZR using Tapatalk 2
  22. I would imagine that my agency would. Education rooms make great sleep rooms, unless you have a policy to continue to hold CPR refreshers during a zombie apocalypse. Sent from my DROID RAZR using Tapatalk 2
  23. My service uses a top of the line cad system, all Motorola APX radios on a digital system and we still carry alpha numeric pagers. They work and their coverage is generally impeccable... Assuming you are speaking about alpha pagers. If your coverage sucks on then, there may be a booster system you could purchase through your communications dealer ata price that isn't outrageous. There also is software that you can run through your computer and a radio card and you can pull data directly off of the pager control channel, but I don't know how discriminating it always is. If it is a voice pager system, perhaps an old mobile radio could be outfitted in your station. Someone with a little radio know how could do it for around $100, maybe $150 if you want audio plumbed into every room. Sent from my DROID RAZR using Tapatalk 2
  24. PBS's Frontline did a really decent job of addressing it in their episode, " The Suicide Tourist." I watched it on Netflix, and would suspect it is still there.
  25. We added these with our new fleet. http://serenitysafetyproducts.com/ They ring in around $4k, but from a legal sense, they are about the best option. We also have the PediMate, but my feeling on it can best be summed up as "Blegh." The Idea of bringing the child in a car seat makes a lot of sense also, so the parents have a safe way to transport the child home. Plus a loose Cheerio may come out...
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