mediccjh

The new PA Protocols require 2 EMTs on a BLS truck.

You did the right thing turning that skel in.

Hence the reason we perform "serial" ECG's. As well, ever seen non "q" wave AMI's? In fact one of the old test questions from ACLS was " a normal XII lead, excludes an AMI?"..

Like Doc described not all AMI's have ECG changes.

R/r 911

You mean when you didn't have to hold hands to pass? I long for those days.........

Damn! no telling people to kiss off? lol

Well, that is part of the reason I would like to come back. Jersey is HOME to me. I have friends, and family there. I want to see them get the best care they can receive. If that means me leaving a warm, RED state, to go to a cooler, BLUE state, well, so be it.

When your patch is not wet, then you can tell people off.

1. Pass your NREMT-P.

2. Get hired by a MICU Project. They will have to sponsor you.

3. Fill out paperwork from MICU Project Education Coordinator for Reciprocity. You can only get the paperwork from the Education Coordinator.

4. Wait a month.

5. Get MICP card in the mail. Your MICU Project will get a copy of the card also.

6. Be a good Paramedic for the 6 months you're on probation. If you're a good person, you will lose the "T" at the beginning of your number.

7. Join us smart medics in overthrowing the regime, to help pull NJ out of the Dark Ages!!!

Congrats!!!! Go out and heal the Amish!

Unless ALS can start doing brain surgery, ALS will not do anything life-saving for a head injury? Pop a line and check a sugar.

However, if there is confusion, and the airway starts to go, that's when ALS will prolong death..er, save a life.

Bruce Leroy, Paragod of the Ghetto.

Anyone recognize the movie reference?

Basically. There's so many medics who don't truly care about the job because they were sent there or went to medic school in order to get hired as a FF though they hated medicine, that a lot just do the very basics on every call. No critical thinking required.

When I asked a medic instructor why the protocols were so basic, he sighed and answered "competence". The less they have to do and think, the less they can fuck up. And with the number of medics and large call volume they have, they're bound to have a lot of screw ups...aka lawsuits.

Also, Los Angeles City FD can do a bit more without making base contact than Los Angeles County FD can...tells you a bit about level of competence expected from them.

There are a few good medics out there, though. Some you can tell do real well within the limited system they were trained in...and others you can actually see they either went to a fabulous medic school or do a lot of off-duty self-educating.

I was blown away on an OT shift last week where a medic would actually stop to explain to us why he was doing everything and what led him to that decision. He even went to into dosages! He spoke of albuterol in terms of 5.0 and 2.5, not as "two things" or "one thing" like everyone else! Then, on an abd. pain I caught him checking to see if palpation would affect patient's inhale/exhale (forget what that test is called)...but I've NEVER seen anyone else do that....so at least there's some hope! I know where I'm going to pick up OT from now on....

Further proof that the firemen shouldn't be running EMS, but that's another topic.

Looking back on my Paramedic class experience, it was scary, and I shouldn't be a Paramedic. I didn't see a lot of sick people, and I only needed about 65-70 ALS patients before my clinical time/internship was done. That's scary looking back on it now. That being said, I did have some strong Paramedics take me under their wing and guide me the right way. Between that and my thirst for education (which meant a lot of self-study), I think I turned out OK. Or, that's what they say.

I definitely believe that the Paramedic program needs to be a degree program, with a long internship program. One of the good things about NJ's Paramedic requirements is the number of hours required. It's about 800 I think (I'm not sure). The other benefit is that since MICUs are spread out in NJ, there is more opportunity to see sick people. Add in a busy system (like Newark, highest per-capita in the nation), and the opportunities to do things can be endless.

The biggest problem in EMS "education" (I use quote because these days it is a joke) is its stupidification. The material is created to teach to the lowest common denominator, as was explained about LA in the previous post. We need to educate INTELLIGENT people who want to be kick-ass Paramedics, not some wacker who only wants it for the blue lights, stickers, and badges. We need to weed out the wanna-bes from the true recruits, and educate them.

The other problem is how we, as an entity, treat and eat our young. Yes, there is a time and a place for it, but we can be brutal. Am I guilty of it? Yes, at times, but only to those who I don't believe have a place in this field.

I do work in a limited EMS System. People call New Jersey a "Mother-May-I" system. While that is true when it comes to standing orders, the fact that separates the great medics from the shitty ones are the protocol monkeys. When I call the doctor, I ask/tell them what I want, not sit there and wait for the doctors to tell me what to do. It's called thinking outside the box, because 95% of our patients do not read the textbook before they pick up that phone.

I'm going to agree that we need a total collapse of the EMS system and start from scratch. Either that, or someone important needs to die. Only then will the higher-ups realize that we have a system that needs to be fixed fast.

What do I have in my arsenal to tell if this isn't a underlying cardiac problem?

Your assessment.

I don't bust out the ALS toys until I'm done with my assessment, including vitals, to determine whether or not my patient is sick or not sick.

I HIGHLY recommend the AMLS program. I finished it today, and it was worth it.

That's when you say to the one objecting,"Fine. It'll be easier to transport you when you're dead."

That usually works.

Guess "ONLY" is to big a word for a ghetto paramedic.

Proofread:

(I) guess "ONLY" is too (not to) big a word for a ghetto paramedic.

I figure most here would not remember Bill Mauldin. He was a cartoonist in the "Stars and Stripes" military newspaper, back during the Second World War (not that old, myself, but I read a few of his books).

One comic panel he had in his book, "Back Home", showed a couple reading a newspaper, which every headline was Veteran this or Veteran that. One comments to the other, "There's a story of a triple ax homicide on page 17, no veterans involved!"

Figure it this way. After the old adage, "If it bleeds, it leads," for garnering a headline, even so-called "union friendly" newspapers go after public servants, as "they failed to maintain their 'higher standards' BECAUSE they were public servants, and tarnished the image we, the public, have of them." The wording is mine, but you get the idea.

I have one of his books. If you look at some of the comics, you will see that some of the patches on some of the soldiers match my avatar, for he was a Thunderbird.

The wording of the title of the topic did not reflect that only EMTs and EMT-Is should answer.

Suggestion: Put it in the first line of the first thread, like Dust did.

Combi-tube. Only 2 sizes, so less room to take up in the bag.

I'm going to say NO also. Keep in mind, I work in a system where the job volume is about 70/30 leaning towards BLS.

Oversaturation of ALS increases morbidity. It was shown in a study (Los Angeles I believe), and when you think about it, it's common sense.

Let's say a Paramedic Unit works in an area where they get 50 Intubations a year. Put another MICU up, then the average is down to 25. Add another one, and it lowers to 16.67 a year. Add another, and we're talking maybe 8 a year. I don't feel comfortable with that.

ALS doesn't need to be out on toothaches, simple nausea/vomiting, etc. That being said, it is up to the EMT to find out if it is being caused by an underlying problem which could require ALS intervention.

We just started a new airway class called Advanced Prehospital Airway Management (APAM) here in Western PA. The region got a big grant to pay for the course and all paramedics are expected to complete the class over the next few years. The course is free and the instructors are well paid. It is an 8 hour class and is scenario based. Everyone that has completed it so far loves the class and they take away many useful skills as well as new insight into the decision making process involved with airway management.

Live long and prosper.

Spock

Spock,

What are the chances of it working its way to Eastern PA?

Where do I start?

While I respectfully disagree with Dust's belief that all ambulances should be ALS, I believe all ALS trucks should be dual-medic.

I have worked in both EMT-Medic and Dual-medic systems; the latter being where I am currently employed full-time. There are pros and cons for both.

EMT-Medic:

Pros:

-If you have a strong EMT partner, or a medic student, it is almost like working with another medic. Yes, they may not be able to perform the skills; however, if they are good, they will be thinking one step ahead of you and have your equipment ready. My partner at my last full-time job was a medic student, and it was like having another medic with me. We were a great team.

-If you are with an EMT, you are not doing paperwork on any BLS job. When an EMT argues the point with me, I ask them if they can write an ALS chart. That ends the conversation there.

Cons:

-If you have a rookie EMT with a shitty job, chances are you will be working by yourself. You're trying to get 20 things done at the same time with someone who is clueless. It sucks.

-You have an EMT who thinks they know-it-all. They will question you in front of the family or patient, or bad-mouth you behind your back. They are the ones who get put in their place in front of the family or the patient. Yes, it sucks, but be a diplomat to the family or patient, and all will be OK.

-If you have a shitty EMT partner, or one who is anti-medic, the lazy factor can come out. They will claim, "Well, it's ALS equipment, so I don't have to do anything." Or, the attitude is, "You're the medic and get paid more, so all I have to do is drive." These are the ones who are usually crying when they work with me.

Dual-medic system:

Pros:

-You have someone to lean back on. If you miss a skill, they can try, and probably get it. My personal rule is 2 strikes. If I am unsuccessful twice on an IV or an ETT (HA!), I will turf it to my partner.

-You have someone to bounce back ideas and treatment modalities on. Yes, everyone has their bad day, or their day when they are off. It helps to have someone who holds the same knowledge (I use that term loosely) with you on the job in case you get stuck.

Cons:

-You have the Paramedics who have the Napoleon complex. It's their way or the highway. Fortunately, I've never have come to fist-o-cuffs. That would be bad, and make us all look really bad.

-You have lazy paramedics. Unfortunately, I have some of them where I work, and when they piss me off, they get relegated to driving duties. I will NOT tolerate lazy paramedicine on da Herbie Bus.

To answer your question Dust, it usually isn't a problem when I'm with another medic. The rule I have on my bus is if one medic wants to treat, it gets done. Discussion after the job. A 12-Lead, Saline Lock, and Blood Sugar check NEVER killed anyone. EMTs on the other hand, yes. I even had a hoople bucket-fairy file a State QA charge against me on a job, which occured during the November 2006 Week From Hell. Needless to say, nothing ever came from it.

I've been a medic for 6 years, which is a twinkle in the eye of most who have posted in this thread so far. However, in those 6 years, I have been working in busy systems, so I think I can hack it with most of youz, and would enjoy a tour with yaz.

I gladly entertain questions from students, as long as they ask it at the right time.

I tell everyone that if they have questions, ask me after the job is over. I tell them this because I don't want all of us to look dumb in front of the family with someone questioning my judgment. If the student or EMT sees something that needs my attention, I tell them to whistle. It works.

I will gladly teach anyone everything I know; however, show the the know-it-all attitude, my goal turns to making you cry.

It's all a conspiracy by the American Heart Association to make us pay more money for their classes. BWAAHAAHAAAA!!!!!

Don't bother wasting your time with I. Go get your paramedic.

So I hear so much about these so called EMT "Boot Camps" that claim to give you all the training you need to be an EMT in just a few weeks to a month and guarantee you will pass. I know my training was just over 6 months at a local community college. I just want to get some thoughts from those experienced EMTs and Medics out there. Are these "Boot Camps" worth what they say? Can one really gain the knowledge they need to go out and save lives in about a month?

No. Easy enough answer.

Opening up these EMT Puppy Mills is only going to bring our profession down.

I work as an EMT-B at a retirement community in PA. We are only BLS here and there have recently been some arguments about what we can and what we can not have in our medical supplies. I know there are only the 6 medications we can administer and or assist with but people have been telling us that we are not allowed to stock and or use certain things on site.

The supplies in question are saline solutions (bottles and eye solution), anti-biotic creams, ammonia inhalants, medicated swabs, burn and or cooling gels, and any other little things like those. I was just wondering if we really are not allowed to use these or even have them available for use. And if we can not physically administer these things, can we supply them to the patient so they can administer it themselves.

Any feedback is appreciated. Thanks.

If you are working for an EMS Agency, refer to PA Act 45 and PA Act 28.

V/S, Mike is correct...once you are a Paramedic in Pennsylvania, you are one for life; however, you are required to attain 18 hrs of continuing education and have your Service Medical Director sign off for you to practice. That is why the PA EMT-P numbers are skewed.

I was raised in a rural system, and now work full-time urban. I've worked full-time urban 3 years. Each system has its pros and cons. I'm glad that because I work in both systems, I'm a well-balanced medic.