mediccjh

I took my ACLS refresher today. What a f--king joke! When I initially took ACLS in medic class in the Spring of 2001, the fear of God was instilled into you if you failed. There was no hand-holding. When you went in for you Megacode scenario, it was you and the instructor, no one else, and if you screwed up, the evaluator let you know about it and failed you. I passed and got the only perfect score in my class. When I went in today, it was a joke. Videos-very cheesy videos that made me want to vomit. Also, the Megacode scenario was a joke! You take the test as a group, with hand-holding and kumbaya, and everyone passes!! It was a horror seeing these doclings and nurses unsure about themselves asking to do things, instead of barking out orders like I did. I was involved in 3 scenarios, and ended up becoming the "team leader" because they didn't have a clue or took no initiative. And of course, everyone passed. And they were impressed that a lowly am'blance driver can intubate!! I talked to the instructors afterward, all whom I have worked with in the field. They all seem to agree with me-that the ACLS curriculum and methodology of teaching is a joke. I find it scary that these are the people in the hospital, who are all allegedly better and smarter than me because they have a college degree, taking care of a loved one in the case of a cardiac arrest. Why is it 2 paramedics and 2 EMTs can run a cardiac arrest better, in deplorable conditions, far superior to hospital RNs and doctors in a controlled environment? End rant. Discuss.

Great!! I didn't get to see last year's issue.

PA now has a plastic certification card. Your cert info on one side, and a picture ID on the other.

I have only had positive experiences with MgSO4 for asthmatics. We are finally getting here in Eastern PA in July, when the [horrid] state protocols go online.

I want to be the Slum Lord. My avatar can be Joe Pesci from "The Super."

Brauns cost a little bit more, but the quality is superior. MedTec is good, and so are Excellances.

It was a wiseass humorous post, people. That's all it was meant to be. Get over it.

Yes, and all the silly people from the rest of the nation call it a RIG. I can get into the bus/job debate if you really, really want. Relax Flyboy, it was in humor. You now owe me a Guinness, or I'll crash my bus into your rig. The bus wins.

NEW RULE FOR THIS THREAD: There will no use of the word "RIG." This is supposed to be a professional thread on how to fix NJ's EMS problem, and the use of the word "RIG" is about as unprofessional as being called an ambulance driver. Dean Asystole, you are in charge of enforcing the rule. And charging toll to leave this thread, since you have to pay to get out of NJ anyway.

I think I just fell in love with you, even though you're a volunteer.

No need to apologize. I came from the EMT-Medic system in PA, and it has its pros and cons. I currently work f/t in Jersey, and I like having a dual-medic truck. I also worked NYC which was dual-medic, and I enjoyed it. Don't get me wrong, I didn't mind having an EMT as long as he/she was smart and could keep up with me (my last 2 f/t partners were able to and are now both medics), but I hated having some stupid EMT with me where I was basically working by myself on a crictical patient. As far as number 3, I do have a state pension (crap, I just gave away where I work). The reason I prefer hospital-based systems is because if it's a good system with good medical control, the possibilities of paramedicine are limitless, with progressive "protocols" and more importantly, accountability for crappy providers.

Yes, I still had to go to work during the shutdown, and I still got a paycheck during the shutdown. On to more important things. 1. Abolish the First Grade Council. They are useless, and full of stupid volly hoopies who only care about how shiny their red lights are to feel good about themselves. 2. All EMS agencies, paid and volunteer, MUST be licensed under OEMS. Yeah, the sticker's ugly, but it's worth it. 3. Keep the ALS Hospital-Based, with dual-medics. With how corrupt county governments in NJ are, I really don't wanna work for them. 3.a Keep the two-tiered system. Frees up ALS for ALS patients. 4. Hold the crappy EMTs and Paramedics accountable for their actions. 4a. Hold the EMS organizations accountable for not keeping the ambulances staffed 24-7. NJ is the most densely populated state in the nation; there is no reason that this can't be done. If it means regionalization of BLS units and providing paid staff, oh well. There are other hobbies out there. 5. Teach the EMTs not to be ALS-dependent for everything. This requires education. If anyone pulls the "well, I'm a volunteer card," take their EMT card away. Now I wanna see how many people I pissed off.

Would that be Tussin? It's the only T I can think of that looks like a gel. Hi-flow O2, BVM, ETT if needed IV or IO, blood sugar Narcan 0.1 mg/kg Dextrose if blood sugar <60 mg/dL Next time, take that pill that says W for Water, or P for Placebo.

If you have a time-critical patient, that is what the rapid extrication is for - removing a critical patient expeditiously.

However, once you put your Paramedics in your cheap ambulance, and they are dispatched with BLS for an ALS assigment that ends up being BLS, with no BLS responding, your medics now must dispatched the stubbed toe while the AMI 2 miles away has to wait an extra 20 minutes for the paramedics. This debate can go around and round. My Utopian society is professional BLS providers in a transport-capable ambulance w/ ALS chase fly cars, this way ALS is kept for more serious emergencies, which is what the original concept was.

It sucks because the volleys can't/won't get out during the day for grandma having the CVA, but if an MVA w/ entrapment come in, they come out of the woodwork. It's that simple.

Pick the brains of your preceptors. Your brain should become a sponge. Treat your patients not because you need the skills, but because the patient needs them. Go in as if you know nothing, ie, don't tell war stories or brag. Preceptors look at this as fresh meat and will jump on you if you fail.

That's why I just use them for their tax-payer money that pays my salary.

The video subjectifies a debate in this country that has been raging since the Bill of Rights was signed: Freedom of the Press vs. Right to Privacy. As public health professionals, it is our job to enforce the right to privacy. That being said, there is nothing that can be done when the videographer has a really good zoom lens.

There are no right answers. Either way, there would have been death. If he woulda let the kids out at 1300, they woulda been on the roads when the twister hit, and more would be dead. You're damned if you do, damned if you don't, and damned when it's done.

It's all in the numbers, bro, which I pulled out from under my kilt. A study was done, I belive in LA County, that showed oversaturating an area with ALS units caused higher mortality rates. The belief is simple: oversaturate an area, the number of patients an individual sees goes down, and more importantly, the number of skills the provider does, ie endotracheal intubation. This is why I fully support a two-tiered system of educated BLS and ALS. You don't need ALS for a toothache.

Rid, With the Wang numbers, there are a lot of flaws: 1. The condition of the airway when a medic first intubates. How many times does it take 2 attempts since you have to suction the oropharynx, find the cords, etc? 2. The numbers, I believe, stem from the fact that most of Pennsylvania is rural. The highest population in PA is east of the I-81 corridor, due to these things we have here that you don't in OK called mountains (Just busting your chops, bro). Looking at my part-time job's statistics, there were only 6 endotracheal intubations last year, company-wide. This is a service that does about 2600 911 jobs a year, with a huge coverage area. In comparison, the company that I used to work full-time for, does 40000 jobs a year (both emergency and non-emergency), and I had 10 intubations there (14 total for the year including Newark). Sometimes, the numbers are just not there, and it's not due to oversaturation of ALS (though you know I agree with you that the oversaturation of ALS kills patients). One must remember, as with all studies, numbers are skewed. As a closing statement, I truly believe that education is the key. Being that I live and work in PA, I can't wait to get my hands on Etomidate. It'll be nice to have more tools to help take care of my patients in the boonies.

Yes, I also own the Special Edition DVD of Monty Python and the Holy Grail.

Which leads to a busy weekend in the ghetto......

I'm disappointed in all of you. I would think you woulda picked up the sarcasm when I asked what a RIG was. RIGS dig oil out of the ocean, or have 18 wheels. Tsk, tsk, tsk.