scott33
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Posts posted by scott33
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I know medics locally in NYC who make 165K a year but they work 4 jobs and 120-130 hours a week
That is insane...but no doubt true.
Welcome to New York
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Hiya..i'm coming over in a couple of weeks to see about a job up in Seattle..This visit wil be a holiday and a chance to see if i'll be happy there..I have a friend who has been talking to his bosses about me getting employment there and we will be going to see them when i'm there..So fingers crossed for me
Unfortunately, getting a job is the easy part. The visa is the near to impossible bit for paramedics. You should go back and read some of the replies to your earlier posts. One of which is from someone who managed to "challenge out" the Medic 1 (seattle) program, only to find out, that his qualifications (Msc Cardiology, HPC Paramedic, and Emergency care practitioner) is not even visa-worthy for immigration to the US.
Even if the role of Paramedic was one of the sought-after jobs in the US, your potential employer would not only have to spend thousands of dollars petitioning your visa (someone else always has to petition on your behalf, you can't do it yourself) running background checks, proving to the USCIS that you will not become a financial burden etc - but also, they will need to prove that you are not taking the job from a US citizen. Most US employers are totally oblivious to the lengths that THEY have to go to, to employ someone from the UK, so you may get the generic "OK you have the job, all we need is your work authorization"
I am not trying to rain on your parade, but US immigration works primarily on family sponsorship, and unless you have a parent or spouse who happens to have a US passport, things will be pretty impossible for you.
You may want to read this link, taken from the US ex-pats forum which show the only, the only legal ways into the US for Brits wanting to immigrate.
http://britishexpats.com/wiki/Pulaski%27s_...Work_in_the_USA
You may also wish to glance over the many, many posts of those wanting to move to the US, only to find just how difficult it is (legally).
http://britishexpats.com/forum/showthread....light=paramedic
They seem a tough bunch, and don't pull any punches with telling the truth, but there are a few immigration lawyers who post there.
The UK isn't even included in the diversity lottery visa scheme, unlike Ireland and much of the rest of Europe.
This link was provided before, but I will put it up again. It should be the starting piont for anyone wishing to immigrate to the US.
Lots and lots of reading.
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Enjoy your holiday to the US.
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I am too and not buying that .. ILCOR pretty much sets the ALS standards for the world and cardoversion and "weld at will" is a standard in London anyway.
UK don't cardiovert prehospital, and that includes LAS. "Treat the symptoms" is the treatment of choice for any and all symptomatic tachycardias. Doesn't seem to be causing any major issues.
Any citable references to the contrary, as it is pretty hard for me to prove a negative?
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That is kind of what I am saying.
The fragmented nature of US EMS can mean anything from first aid squads to APP / CPP practitioners. From Volly FD who are obligated to do an EMT-B course, to professional flight teams (professional ones I mean) and everything in between.
As for the lack of hours for traditional UK medic courses. I agree it does seem a little short (they would say the same about our driver training, but that's another story) However, the jump from NHS Ambulance Technician - NHS Paramedic is not as great as the jump from EMT-B - Paramedic. The UK paras also don't spend as much time in class on drug math (no piggyback drips) or need to memorize protocols ad nauseum (the latter of which I felt took up too much time on my medic program).
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I will try to be as objective as I can here.
I am a US para, my Brother is a UK para and we often swap yarns, as well as having both seen each others working roles first hand...
The main difference between systems is that the UK do not have a medical control, or physician-based system. The Paramedic is the one who makes ALL the prehospital decisions for the patient. They are completely accountable for all prehospital treatment for their patients. They have their own license to purchase, and carry their own supplies of controlled drugs, including Morphine, so many have their own "personalized" drug bags.
Many in the UK make a stink about working to guidelines, over our protocols. This does allow for a little more freedom in treatment options (and again, this is at the sole discretion of the para), but I believe the guidelines are similar to our protocols in the way they have been laid out, and indeed, the word "protocol" is mentioned many times in the literature. The one good thing is, one set of guidelines more-or-less covers the entire UK (England, Scotland, Wales and NI) Have a look.
http://www2.warwick.ac.uk/fac/med/research...ite/guidelines/
With that extra accountability, comes the ever watchful eye of the UK para's governing body, the Healthcare Professions Council (HPC). The title "paramedic" is protected by law in the UK, and one cannot practice unless they are registered with the HPC. Another plus, at least fundimentally - one overseeing body, not 20 or 30.
However, there is much malcontent among many of the HPC registrants, mainly due to some of the "fitness to practice" hearings. Many have accused the HPC of formulating petty arguments to discredit the registrant ("Not tying hair back during her working shift" was one notable comment made on one of the hearings, though not entirely the reason for the hearing). The Paramedic remains answerable to the HPC throughout their career, whether at work or not, and striking off the register, means they cannot work in the UK as a paramedic again.
Up until recently, all UK paramedic training was done in-house, and after one had been an Ambulance Technician, and had passed their probie period, could apply for pre-selection on a course. Success was based on personal merit, and the courses were generally much shorter than the US ones. These days, a University degree is only way to become a paramedic - there are some trusts lagging implementing this, but they will be phasing out the in-house courses in time. There is no difference in pay for university vs conventional paramedics at this time.
The US seems to have some more advanced clinical interventions than the UK, or at least more "toys" to play with. CPAP has barely taken off in the UK, Pacing and cardioversion are the exception, not the norm, piggyback drips are unheard of, intubation is only ever done on dead patients (no conscious sedation), capnometry is in its infancy, lack of drugs for symptomatic tachycardias (adenosine, cardizem, metoprolol).
However, in rural areas, they do thrombolise MIs - again, this can be completely without reference to a physician (ulp!)
I would say the ideal system would have a combination of both systems (like with healthcare as a whole), and both can learn from each other. UK EMS has the edge things like clinical autonomy and single system regulation; the US has the edge with technology, and in the best of the best systems - clinical practice.
Have to say, I think the training and education is pretty similar.
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Rightly or wrongly, one does not need to be a US Citizen to be allowed to reside in the US, work in the US, pay taxes, claim social security, buy property, vote in local elections, or work for the US armed forces, etc etc.
There are millions of Lawful Permanent Residents who, having satisfied the immigration requirements of the US, are allowed the full integration rights of either natural born, or naturalized US citizens. That is, with the notable exception of working in certain governmental positions, voting in presidential elections, partaking in jury duty, or holding a US passport. These "green card" holders remain citizens of their native country, and as per the USCIS, are under no pressure to take on US citizenship. That part is entirely voluntary, and usually based on individual circumstances.
The LPR obides by the same laws as those born in the US, and also by the laws of US immigration. Their status has to be reviewed and renewed every 10 years, but can be revoked at any time. Illegal Aliens do not have the myriad of documents held on file about their personal details, and every move they make, the way LPRs do, and the two should not be confused. You are either in the US by legal means, or you are not.
It should be noted that many other developed countries have very similar "permanent resident" criteria, to that of the US (see link) and that immigration, including the issues with illegal aliens, is not unique to the US.
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Canada
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I'm not saying let the illegals die, I'm saying stabilize them, then deport for their own country to care for. Any other country would most likely do so to an american citizen that could not cover costs in some form or another.
What costs? And what other Countries?
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Arab
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British
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Wake County EMS (NC) have been doing it for a while. Plenty of articles about it, and their hypothermia protocol is here.
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Well done
You will do well.
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Not only did he never imitate, he never could be imitated.
I am not too sure about that...
Must admit though, seeing his Daughter say goodbye was very sad to watch.
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Spending that extra time on patient assessment skills, instead of dangling from a rope, would make them "super" in my eyes.
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According to your first post, you should now be almost 3 months into your "paramedic training". If you don't know what is what is needed for a basic first aid kit by now, ask for your money back.
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...and P-Q depression.
Pericarditis.
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I agree with all you say, and it is a case of isolation until ruled out.
But, given our different professions, I am in no doubt that you are seeing the more serious cases, whereas I am seeing more of the media-frenzy-induced BS cases of general malaise with associated sniffles, which would ordinarily be treated at home with chicken soup and tylenol. Some of them are not even getting swabbed.
I know we have had a couple of type A admits (versus the many, many more sent home) but as we all know, there are usually other factors or comorbidities present.
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Influenza A is taken serious in hospitals regardless of what animal it is named after and the patient is isolated in hospitals. We have cases pop up year round.
So much so that most are D/C'd home and told to ride it out. I had the one of the iso rooms on my last shift, and had 4 (out of many) who ruled in for type A. Tamiflu and taxi was the dispo and they were in and out of the ED in no time.
just a swingin
in Archives
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