ncmedic309

How about this one...does more meds in your bag equal better patient care? I would like some honest answers here, how many drugs are in your bag/box and how many of those drugs get used on a routine basis?

Do American EMT-XYZ's GENERALLY have too many drugs and too much responsibilty in their scope of practice relative to the amount of education that they recieve?

I think some services have way too many drugs than necessary. You look at some services that have upwards of 40-50 medications in their bag and they might give 15 of them on a routine basis. What's the point in having a large selection of drugs that your never going to use? What's the eduction like for those people, how many of them know the inside and out of each of those medications that never get used compared to the ones used routinely? Too many drugs in the bag can be a bad thing...

Plus 5 to both of the last two posts! :thumbright:

WHERE TO START? IN ORDER I GUESS...i DONT KNOW WHERE YOU WORK HAVE WORKED BUT THE ONLY THING THE PARAMEDIC HAS TO "PECK ON" IS THE EMT BECAUSE MOSTLY, WHERE I AM FROM M.D'S PECK ON US. IT IS NOT A GOD COMPLEX BY ANY MEANS WHAT SO EVER. I HATE THAT TERM. THE REASON IT IS THERE IS BECAUSE THE DIFF. BETWEEN AN EMT B AND AN EMT P IS SO BIG.

I AM ALL FOR INCREASING THE AMOUNT OF CLASSROOM TIME FOR EMT B'S AND MAKING IV PLACEMENT WITH NS OR LR A NATIONAL STANDARD AS WELL AS GLUCAGON, NARCAN (ANY ROUTE), CHARCOAL (AFTER ONLINE MEDICAL DIRECTION), ALBUTEROL COMBIVENT VIA NEB, NITRO, AND HOLD ON TO YOUR SEATS.... PR VALIUM GEL FOR PEDS AND ADULTS. THESE MEDS ARE ESSENTIAL AND EASY TO REMEMBER THE INDICATIONS AND CONTRAINDICATIONS FOR...SIMPLY PUT. I THINK THE EMT CAN BE TRAINED VERY EASILY TO HAVE A LARGER SCOPE AND I THINK IT IS VERY POOR THAT THE NATIONAL STANDARD IS SO LOW.

HOWEVER, THERE ARE SO MANY EMT'S WHO DONT CARE AND LEARN THE MINIMUM AND ONLY DO WHAT THEY ARE ASKED AND THE WILL NOT DO AN ASSESMENT PRIOR TO ALS ARRIVAL BUT JUST GET A CC AND A SET OF VITALS. THEY ACCEPT THAT THEY ARE THE LOWEST ON THE CHAIN. B.S. YOU WANT RESPECT FROM A MEDIC, EARN IT. ASK QUESTIONS AND SHOW HIM THAT YOU ARE TRYING TO LEARN ON YOUR OWN OR ARE TAKING ACLS, PALS, PHTLS, AND AMLS,. PROVE TO ME THAT IF I ASK YOU TO DO A TRACTION SPINT YOU CAN DO IT.

AS FAR AS THE 12 LEAD... NO WAY...SORRY MOST MEDICS CANT FULLY READ A 12 LEAD. SIMPLY PUT. I USED TO SEE THIS BLS RIG AT UCLA (WHO WERE EMT D'S) BRING PATIENTS IN ATTACHED TO THE AED BECAUSE IT DISPLAYED THE RHYTHM ON THE AED....CRAZY.

A LOT OF CHEST PAINS ARE BLS, CHEST WALL TENDERNESS IS A MUSCULAR PROBLEM, PNUEMONIA IN A YOUNG ADULT CAN CAUSE IT...THERE ARE A BILLION REASONS WHY CHEST PAIN IS NOT 100% ALS.

COMPLAINING ABOUT A CODE IS A PERSONAL THING, MOST MEDICS USE "CODES" AS PRACTICE OR A TIME TO REALLY SHINE AND REALLY ACTUALLY SAVE A LIFE, SO THAT IS NOT A MEDIC THING, IT IS A PERSONAL THING.

REGARDING THE "OVERSTOCKING OF THE RIG", YOU SAY THAT NOW BUT WHEN AN OLD MAN HITS THE GAS INSTEAD OF THE BRAKES AND PLOWS THROUGH A STREET FULL OF PEOPLE DURING A FARMERS MARKET IN SANTA MONICA AND YOUR UNIT IS STOCKED TO THE BRIM WITH EXTRA SUPPLIES, YOU WILL LOOK DAMN COMPETENT AND NOT INSECURE. STATE STANDARDS ARE B.S. AND ARE THE VERY BOTTOM LIMIT. A GOOD MEDIC WILL HAVE AT LEAST DOUBLE THE AMOUNT BUT HAVE THEM IN SEPERATE PLACES IN CASE YOU LOSE SOMETHING OR FORGET TO RESTOCK OR THERE IS A MCI ETC...

IF IT IS A THUMB LAC ONLY THEN WHY IS THERE AN ASSEMSSMENT BEYOND "WHY DID YOU CAL 911". IF YOU WANT TO DO A FULL ASSESSMENT AND WORK THAT PT UP AND TRANS, GO RIGHT AHEAD.

EMT'S ARE BELOW PARAMEDICS SIMPLE AS THAT. I FIRMLY AGREE THAT THEY SHOLD HAVE A BROADER SCOPE. HOWEVER, AS AN INSTRUCTOR YOU WOULD NOT BELIEVE SOME OF THE INCOMPETENCE I SEE DURING RE-CERTS. SO IF YOU DONT EVEN KNOW YOUR BASIC Ca Ca, HOW ARE YOU GOING TO GET THE RESPECT AND THE ABILITY TO EXPAND YOUR SCOPE?

DONT BLAME THE MEDIC, LOOK AT YOUR SELF. YOU CAN NOT BE A GOOD EMT WITHOUT BEING A GOOD MEDIC.

A GOOD EMT WILL ANTICIPATE THE MEDIC'S NEEDS AND WILL MAKE HISHER LIFE EASIER, AND THUS MAKE BETTER TX FOR THE PT. IT IS THAT SIMPLE.

You're an instructor? Your grammar is horrible, your professionalism and tact is lacking severely, do you want me to continue? You seem to think mighty highly of yourself, but I'm willing to bet most medics and EMTs can probably run circles around you.

Sounds like the paramedic is a spastic idiot...that patient needs high-flow oxygen...

No, actually I'm not wrong on this actually. I didn't say the EMT would be held blameless, I mearly stated that if he or she did something asinine the medc would swing for it. Personally, if I'm having my whole life flushed down the toilet because of somebody else's behavior or action, then it is only small consolation that the other person is forced to find a new hobby.

What I'm really getting at is attitude. Yes, even the non-psychological complex medics can be pushy jerks at times, but its not a power trip, its a matter of survivial. You want to be a hero and do things your way and all that happy cowboy horsecrap? Fine, here's a Gall's catalogue, have a blast.

I have a life though. I have rent and bills to pay, and a whole bunch of things that depend on me having a job to support myself. So if I have to be a little pushy about it, so be it. If make someone feel inferior because they were about to do something that to get me fired, I'll drive them to group therapy and we can all talk about our emotions. I have orders to take and procedures to follow that are really not open to interpretation from the peanut gallery. If an EMT has a problem with that, I really don't care and I really don't think I need to express that in a positive constructive manner. I mean, sure, I'll try, but if push comes to shove, I'm going to get my way one way or the other.

I agree with you, when it comes to protecting your career, you have to do what's necessary to take care of business. I think it's wrong that any person should reap the consequences of somebody elses mistake. If your trained and certified, you should know your scope of practice and your limitations, and you should be held to them at all times. If you deviate from them then you should be punished accordingly. You can't prevent the actions of some idiots, but you have to look at it from the stand point of "we have a fucked up government and nothings going to play in your favor when it comes that time..."

It's actually quite common that some EMTs and Paramedics have hearing problems. They make special scopes and some services will even buy them for you if it's a necessity to do the job. I don't have any direct links to companies but if you do a search, you shouldn't have any problems finding a good scope to suit your needs.

That's what everyone has been saying, I'm glad I picked the choice of careers I did, but man, I fear paramedics after reading this board sometimes.

There's no reason to fear paramedics, I wouldn't even fear some of the dumbasses out here that call themselves paramedics. There's a lot of idiots in EMS, some of them are right here in this forum, don't let them or anyone else change your views of EMS...

Not impressed. The typical EMT devotes all his time to that sort of crap -- spiking bags, tearing tape, and running strips -- in the mistaken belief that it is helping him (cuz few of them are really interested in helping anybody but themselves), and lets his EMT book gather dust at home, never again opening it up to study MEDICINE and truly improve himself. Does it help me to do all those silly little monkey tasks for me? Sure. Thanks. But I will be MUCH more impressed with you if I see you actually studying on duty and taking college classes off duty rather than constantly hounding me about learning some other skill you don't have the education to use.

I'm never impressed by anything you have to say, since the majority of it belongs in a nice big smelly pile of shit! Why not just make the attempt to be "open-minded" for just one day?

Eliminating the basic level from 911 ambulance EMS would be a very, very good step in the right direction. The current level of training is wholly inappropriate for somebody who has ultimate transporting responsibility for emergency patients. It's just first aid. It's appropriate for first responders, and that's it.

I actually tend to agree with most of your comments except this one in particular. There are way to many areas of the country that depend on basic EMTs for EMS services in general. There are some areas of the US that you'll be lucky to have anybody skilled pass the EMT level attend to you if you need emergency services. Just take a look at the comparison chart from the JEMS website that somebody posted in the other thread, the comparison of EMTs to advanced prehospital providers. In a perfect world, nothing but ALS ambulances would be ideal, but it will never happen. Instead of eliminating the basic level from 911 ambulances, which would wipe out a lot of fleets, we need to focus on much better education for those EMTs. Let's make them better at the jobs they are supposed to do so they can be utilized more efficiently. That's the answer to our problems unless you can turn all those EMTs into paramedics, that would be a even better solution.

Yes Rid, we learned all those things in Basic class Spiking a bag, IV setup et al. A portion of the class called ALS assist. I like the fact I can do things to help my medic partner. If I can free her to perform more advanced procedures like starting IV's or placing a ET tube, then It's a good thing. Or am I wrong here?

Your not wrong, your right on! As an EMT your play a very important role in assisting your paramedic partner on the truck, just as you stated. Theres tons of things you can do on the truck to help out your partner. When you get done with school, you will see just how much your partner appreciates your efforts as an EMT. A good EMT partner is priceless...

i have 2 jobs because emt in west virginia get paid $6.25 where I live.I have been curious how much they make in other states if you dont mind telling.I know the cost of living can play a factor but cum on..medics make $7.50.we both deserve more for what we all do

Wow! That's pathetic, your right, you both deserve more for what you do! There's no way I could do this job for that amount of money, there should be a law that sets your pay minimum well above the rates you stated.

I've been reading this forum for a few years, and just now decided to register... Seems to be the popular thing to bash anyone for any reason. Ask a question, get bashed, flamed, or called an idiot.

As long as you’re not a volunteer (doubly bad if you're from New Jersey); a Basic EMT (god forbid a first responder); thin-skinned or highly self conscious; have poor grammar or spelling skills; or basically do not know less than the first person who replies... You'll be okay.

Used to be much worse! A few people left, started bashing on other forums; emtlife, trauma central, ems village, etc. Same crap, same people; just makes the place more interesting. Prolly the only reason I come back to read it a couple times a month. Almost like real life, except I don't think anyone on here has killed another user, yet..?

There are some people here (and everywhere else) that seem to think others are inferior to them because they don't have as many years of service or don't have the same certifications/licensure/degrees as they do. They disagree with anyone and everyone if it isn't done their way and won't hesitate to bash/attack another member if you disagree or do it differently. Fortunately the number of those people are fairly small and leave little impact on things. Remember, just because a person has more years of experience or a higher certification doesn't mean they know what they are doing and it certainly makes them no better than anyone else.

Where did I mention anything about a badge giving me or anyone else authority? Try reading my post again...

Authority - "the power to influence or persuade resulting from knowledge or experience"

Take that definition and apply it to the job that we do...You can be hard-headed and only see it from one view or you can look at it for what it is, and attempt to understand the point I'm trying to make. It really makes no difference to me, I know how to do my job, and I know all about the authority I have and where it reaches. I don't use it to make myself feel better about anything, I use it to make the best decisions possible when caring for my patients. Not "everyone in america" has that authority, nor the knowldege or experience to use it properly.

Never.. I will not tolerate bad behvior, but yet again I don't off duty as well, but to really use authority ?.. I think we are getting way too much of ourselves..

Like Admin described this has been discussed several times...

R/r 911

It might have been discussed several times, but I didn't get to put my 2 cents in on it. It's not about "getting way too much of ourselves", it's about doing what it takes to get the job done. Quite simply put, you have the authority to restrain a patient vs. letting them kick your ass in the back of the truck, you have the authority to force a patient that is mentally unfit to make their own decisions seek further medical care. Believe it or not, even us EMS folks have some degree of authority.

I always figured that's just something that ego maniacs say... As far as saving lives, my partner and I are always on the same level. If you can't respect the EMT, then you need to take a step back, after all, Basic doesn't mean less. It means essential skills. Our job (Paramedics) has the same essential skills, with out them, we'd have nothing.

That was very well put, agree 200%.

LMAO! That's awesome!

If your right and you can prove it, you can buck a paramedic, a doctor, another EMT, whatever all day long and you have the right to do so! Just because somebody has a higher certification than you or has held a certification longer (even at the same level) doesn't mean they have a clue as to what they are doing!

The badge obviously looks more professional, but it gets you mistaken for law enforcement quite often. I can't tell you how many times I've been called an "officer"... I disagree with the comments about no authority, regardless if you wear a badge or not in EMS, you still have some degree of authority, and people still see you as a authortiy figure. You might not have the same authority as a law enforcement officer, but it's still there...think about it...how often do you use it on a daily basis to get the job done?

There already are 52 levels of EMS training, why not add a couple more... :roll:

Just one of the many problems with the EMS education systems around the country...why can't we just knock it down to a few standard levels...wouldn't this help education in the long run...and provide better standards of care for prehospital care providers around the US?

Give this link a try...

EMT - Enhanced

Increased accident rate. Cops have been constantly crashing and dying because of driving while watching their MDT. I hope systems that put these things in their units have the sense to mount them visible only to the passenger seat. But I seriously doubt it. Certainly wouldn't put one in my units visible to the driver. I care more about my people than to do something that stupid.

I guess us medics are a little smarter than the cops. We haven't had any accidents in the almost 4 years that we've had them secondary to the driver paying attention to the computer screen. It's actually quite easy and safe to use, your partner sitting next to you navigates as usual, how many times do you look over at the mapbook that your partner is navigating you out of while your driving emergency traffic, I can't recall ever doing it...same thing with the mobile PC. And when your enroute to a hospital, you shouldn't need a map, you should be familiar enough with your county that you can navigate yourself to the destination by recall alone. The mapping system works great, it's the idiots that don't use them properly that run into problems. If your running alone in a vehicle (such as a police officer) you shouldn't have your head turned away from your driving, same principle as driving and talking on a cell phone, pay attention to what your supposed to be doing and you won't end up injured or worse...it's an easy rule to live by...

I think it's an abbreviated form of the EMT-Intermediate course...

We've had them for several years now along with a mobile mapping system. I don't see a downfall to having them, if anything it improves the system. It makes it a lot easier for your dispatch to keep an eye on you, and it's a lot harder to hide, but it works...

You begin treating the patient for reactive airway disease/COPD and realize that it's actually a cardiac issue, you change your course of treatment. I hate the term "treat and trash", but sometimes it happens and there's not much you can do about it. Your patient presents one way, you can't get a better history, you have to treat what you see. Just be sure to reassess for changes. If it starts looking like something else, discontinue your original care and begin your new treatment modality. It seems this patient began presenting like your classic COPD/Asthma case, and then heart failure showed it's nasty face...

As far as further treatment, nitrates, diuretic, and CPAP. If the patient has a hx of COPD (more specifically emphysema) make sure you have the ability to lower your cm H2O (pressure range) so you don't "pop" any blebs when using a CPAP machine...